SynthesisMedicine2020
Clinical efficacy and safety of spironolactone in patients with resistant hypertension: A systematic review and meta-analysis.
Synthesis in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- A European Renal Association (ERA) synopsis for nephrology practice of the 2023 European Society of Hypertension (ESH) Guidelines for the Management of Arterial Hypertension.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Guideline
- Risk of heart failure in ambulatory resistant hypertension: a meta-analysis of observational studies.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Pooled it
- Efficacy of spironolactone as adjunctive therapy to sodium valproate in bipolar-I disorder: A double-blind, randomized, placebo-controlled clinical trial.Brain and behavior · 2023Trial
- Dose-response efficacy and safety of the aldosterone synthase inhibitor baxdrostat in resistant hypertension: a systematic review and network meta-analysis.Naunyn-Schmiedeberg's archives of pharmacology · 2026Review
- Mechanisms for Mineralocorticoid-Driven Age-Related Hypertension: Potential Therapeutic Role of Mineralocorticoid Receptor Antagonists and Aldosterone Synthase Inhibitors.Circulation research · 2026Review
- Article
- Unmasking Secondary Hypertension: Renal Artery Stenosis Concealing the Diagnosis of Primary Hyperaldosteronism.Cureus · 2025Article
- Guidelines for the management of hypertension in CKD patients: where do we stand in 2024?Clinical kidney journal · 2024Article
- The Global Burden of Resistant Hypertension and Potential Treatment Options.European cardiology · 2024Review
- Primary Aldosteronism and the Role of Mineralocorticoid Receptor Antagonists for the Heart and Kidneys.Annual review of medicine · 2023Review
- National Heart Center/Saudi Heart Association 2023 Guidelines on the Management of Hypertension.Journal of the Saudi Heart Association · 2023Article
- Mineralocorticoid receptor activation and antagonism in cardiovascular disease: cellular and molecular mechanisms.Kidney international supplements · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe conducted a meta-analysis to summarize all available evidence from randomized controlled trial studies regarding the clinical efficacy and safety of spironolactone in patients with resistant hypertension (RH) and provided a quantitative assessment.
methodsA systematic search of PubMed, Web of Science, Cochrane Library, Embase, and China National Knowledge Infrastructure (CNKI) databases through December 8, 2019, was performed. Randomized controlled trials randomized controlled trials meeting inclusion criteria were included to assess the effect of the addition of spironolactone on office blood pressure (BP), 24-hour ambulatory BP or adverse events in RH patients.
resultsTwelve trials, which enrolled a total of 1655 patients, were included in this meta-analysis. In comparison with placebo, spironolactone significantly reduced office BP (office SBP, weighted mean difference [WMD] = -20.14, 95% CI = -31.17 to -9.12, P < .001; office DBP WMD = -5.73, 95% CI = -8.13 to -3.33, P < .001) and 24-hour ambulatory BP (ASBP, WMD = -10.31, 95% CI = -12.86 to -7.76, P < .001; ADBP, WMD = -3.94, 95% CI = -5.50 to -2.37, P < .001). Compared with alternative drugs, spironolactone treatment in RH patients significantly decreased 24-hour ambulatory BP (ASBP, WMD = -6.98, 95% CI = -12.66 to -1.30, P < .05; ADBP, WMD = -3.03, 95% CI = -5.21 to -0.85, P < .001).
conclusionThis meta-analysis fully evaluated the antihypertensive effect of spironolactone compared with placebo, alternative drugs, renal nerve denervation and no treatment. Spironolactone can result in a substantial BP reduction in patients with RH at 3 months.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.