Spironolactone in Hypertensive Patients: Oligemic and Antihypertensive Effects

Steroidal lactones have been reported to produce sodium diuresis and potassium conservation in primary or secondary aldosteronism 1,2 . When given with a thiazide compound, they always reduced potassium excretion and increased that of sodium. 3 Spironolactone, synthesized by Cella and Kagawa blocks the urinary electrolyte effects of desoxycorticosterone acetate in rats. 4 Similarly, it blocks the renal effects of aldosterone presumably through a direct antagonizing action. 5 In hypertensive patients with unrestricted sodium intake, spironolactone is hypotensive according to Hollander, Chobanian and Wilkins. 6 The present study was undertaken to determine the oligemic and antihypertensive effects of spironolactone * in non-edematous hypertensive patients with, or without, other antihypertensive therapy and compare them with those obtained with hydrochlorothiazide † alone or in combination with this steroid. Methods Used Seven patients hospitalized in the Research Ward of the Cleveland Clinic Hospital were used for this study; 4 had essential hypertension which in one