Effects of spironolactone on exercise blood pressure in patients at increased risk of developing heart failure: report from the HOMAGE trial.
Coronary heart disease
Exercise capacity
Heart failure
Incremental shuttle walk test
Spironolactone
Journal
Hypertension research : official journal of the Japanese Society of Hypertension
ISSN: 1348-4214
Titre abrégé: Hypertens Res
Pays: England
ID NLM: 9307690
Informations de publication
Date de publication:
06 Sep 2024
06 Sep 2024
Historique:
received:
14
05
2024
accepted:
23
07
2024
revised:
13
07
2024
medline:
7
9
2024
pubmed:
7
9
2024
entrez:
6
9
2024
Statut:
aheadofprint
Résumé
None of the spironolactone trials in heart failure (HF) assessed the blood pressure (BP) responses to exercise, while conflicting results were reported for exercise capacity. In the HOMAGE trial, 527 patients at increased HF risk were randomized to usual treatment with or without spironolactone (25-50 mg/day). The current substudy included 113 controls and 114 patients assigned spironolactone, who all completed the incremental shuttle walk test at baseline and months 1 and 9. Quality of life (QoL) was assessed by EQ5D questionnaire. Between-group differences (spironolactone minus control [Δs]) were analyzed by repeated measures ANOVA with adjustment for baseline and, if appropriate, additionally for sex, age and body mass index. Δs in the pre-exercise systolic/diastolic BP were -8.00 mm Hg (95% CI, -11.6 to -4.43)/-0.85 mm Hg (-2.96 to 1.26) at month 1 and -9.58 mm Hg (-14.0 to -5.19)/-3.84 mm Hg (-6.22 to -1.47) at month 9. Δs in the post-exercise systolic/diastolic BP were -8.08 mm Hg (-14.2 to -2.01)/-2.07 mm Hg (-5.79 to 1.65) and -13.3 mm Hg (-19.9 to -6.75)/-4.62 mm Hg (-8.07 to -1.17), respectively. For completed shuttles, Δs at months 1 and 9 were 2.15 (-0.10 to 4.40) and 2.49 (-0.79 to 5.67), respectively. Δs in QoL were not significant. The correlations between the exercise-induced BP increases and the number of completed shuttles were similar in both groups. In conclusion, in patients at increased risk of developing HF, spironolactone reduced the pre- and post-exercise BP, but did not improve exercise capacity or QoL.
Identifiants
pubmed: 39242826
doi: 10.1038/s41440-024-01843-z
pii: 10.1038/s41440-024-01843-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Kei Asayama
(K)
Erwan Bozec
(E)
Hans P Brunner La Rocca
(HP)
Franco Cosmi
(F)
John G F Cleland
(JGF)
Tim Collier
(T)
Javier Díez
(J)
Frank Edelmann
(F)
João P Ferreira
(JP)
Nicolas Girerd
(N)
Stephanie Grojean
(S)
Mark Hazebroek
(M)
Stephane Heymans
(S)
Tine W Hansen
(TW)
Javed Khan
(J)
Begoñia López
(B)
Roberto Latini
(R)
Beatrice Mariottoni
(B)
Ken McDonald
(K)
Gladys E Maestre
(GE)
María U Moreno
(MU)
Mamas A Mamas
(MA)
Anne Pizard
(A)
Burkert Pieske
(B)
Johannes Petutschnigg
(J)
Pierpaolo Pellicori
(P)
Patrick Rossignol
(P)
Philippe Rouet
(P)
Suzanna Ravassa
(S)
Jan A Staessen
(JA)
Lutgarde Thijs
(L)
Job A J Verdonschot
(JAJ)
Fang-Fei Wei
(FF)
Faiez Zannad
(F)
Informations de copyright
© 2024. The Author(s).
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