Posted on 06/01/2025 7:51:19 PM PDT by ConservativeMind
Research has shown amiloride is as effective as spironolactone in reducing systolic blood pressure (SBP) over 12 weeks in patients with resistant hypertension.
Spironolactone is a fourth-line medication. Adverse effects, particularly hyperkalemia and hormonal disruptions, limit its use in long-term care. Amiloride, a potassium-sparing diuretic, lacks these hormonal side effects, making it a potential replacement candidate.
In the study, researchers conducted a prospective, open-label, blinded end-point trial to assess whether amiloride could provide comparable SBP reduction to spironolactone in patients with resistant hypertension.
Researchers enrolled 118 participants at 14 hospitals across South Korea. Participants ranged in age from 19 to 75 years and had sustained hypertension despite a four-week run-in period on a fixed-dose triple combination of a renin-angiotensin system inhibitor, calcium channel blocker, and thiazide diuretic.
Participants were randomized 1:1 to receive either 12.5 mg/d of spironolactone or 5 mg/d of amiloride. Dose escalation was permitted after four weeks for those with home SBP at or above 130 mm Hg, increasing to 25 mg/d for spironolactone and 10 mg/d for amiloride. Home BP measurements were recorded twice daily, and adherence was monitored through pill counts.
At 12 weeks, mean home SBP decreased by 13.6 mm Hg in the amiloride group and 14.7 mm Hg in the spironolactone group, a noninferior difference within the trial's prespecified margin (−4.4 mm Hg). Target home SBP below 130 mm Hg was achieved by 66.1% of patients receiving amiloride and 55.2% receiving spironolactone. One case of hyperkalemia-related discontinuation occurred in the amiloride group; no gynecomastia cases were reported in either group.
Researchers concluded that amiloride demonstrated noninferior efficacy in reducing SBP compared to spironolactone in patients with resistant hypertension, suggesting its potential as an alternative for those intolerant to the adverse effects of spironolactone.
(Excerpt) Read more at medicalxpress.com ...
Walgreens appears to carry this for $15 a month, with a GoodRX discount.
Don't believe anything out there from drug companies or cardiologists that are part of a large group practice.
Don't believe anything out there from drug companies or cardiologists that are part of a large group practice.
Valsartan works best for me (I had an enlarged heart). Amiloride has waaayyyy to many undesirable side effects. It will turn you a purple-blue. They tell you to wear sunscreen and stay indoors if taking it. It also made me very nauseous and night sweats. And then of course watching for your pecker falling off ain't so good either?
Valsartan dropped my blood pressure average from 130/80 to 95/65. Sometimes it drops too low and I need to pedal my exercise bike to stop feeling dizzy. I never have had other symptoms of heart disease, cholesterol issues, or artery hardening. I have Left Branch electrical problems. Left branch bundle block. Always had it. In my 50’s the mismatched pumping between chambers began to enlarge my heart. At 61 I had a Bi-ventricular pacemaker put in. Between the pacemaker and Valsartan I am doing great.
bkmk
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