"Plach\u00FD, M." . . . "RIV/00843989:_____/12:00102515!RIV13-MZ0-00843989" . "1212-4184" . "L\u00E9\u010Dba spironolaktonem u pacient\u016F s rezistentn\u00ED arteri\u00E1ln\u00ED hypertenz\u00ED (studie ASPIRANT)"@cs . "N" . "P\u0159\u00EDl. \u010D. 1" . "At present, there is relatively little information available regarding which drug should be preferred in treatment of resistant arterial hypertension. Observational studies suggest that spironolactone could be a potent drug to treat these patients. This study was initialised in order to evaluate the efficacy of spironolactone in lowering blood pressure (BP) in patients with resistant hypertension. The patients enrolled into the ASPIRANT multi-centric, double blind, placebo-controlled study had an office systolic blood pressure of over 140 mmHg or diastolic blood pressure of over 90 mmHg, despite being treated by at least 3 antihypertensive drugs, including a diuretic. 119 patients were randomly assigned to be use either 25 mg of spironolactone daily (n=59) or placebo (n=58). Our primary aim was to find a significant difference in the decrease of average daytime systolic and diastolic blood pressure on ambulatory blood pressure monitoring (ABPM), between the groups treated by spironolactone and placebo, after 8 weeks of treatment. The analysis was performed using data from 111 patients (55 in the spironolactone group and 56 in the placebo group) After 8 weeks, the difference in the decrease of average daytime BP between the groups was -5,4 mmHg (95% CI -10.0; -0.8) for systolic (p=0.024) and -1.0 mmHg (95% CI -4.0; 2.0) for diastolic BP (p=0.058). The average night-time systolic BP, as well as average 24-hour systolic BP and office systolic BP were significantly decreased by spironolactone (difference of -8.6, -9.8 and -6.5 mmHg; p=0.011, 0.004 and 0.011), while the decrease of the respective diastolic pressure levels was not statistically significant (-3.0, -1.0 and -2.5 mmHg; p=0.079, 0.405 and 0.079). The only laboratory parameter that predicted a decrease of both systolic and diastolic BP after 8 weeks of spironolactone treatment was the aldosterone/plasma renin activity ratio at the beginning of the treatment. The occurence of adverse effects was comparable i..."@en . . . "mineralocorticoid receptor antagonists; spironolactone; hypertension; resistant hypertension; prediction of response to treatment; age; sex"@en . . "Spironolactone treatment in patients with resistant arterial hypertension (ASPIRANT): randomised, double blind, placebo controlled study"@en . . "V sou\u010Dasnosti existuje m\u00E1lo dat o tom, kter\u00FD l\u00E9k by m\u011Bl b\u00FDt pou\u017Eit ke kontrole tlaku u pacient\u016F s rezistentn\u00ED arteri\u00E1ln\u00ED hypertenz\u00ED. V observa\u010Dn\u00EDch studi\u00EDch se v posledn\u00ED dob\u011B ukazuje jako \u00FA\u010Dinn\u00FD l\u00E9k spironolakton. Tato studie byla iniciov\u00E1na ke zhodnocen\u00ED \u00FA\u010Dinku spironolaktonu na sn\u00ED\u017Een\u00ED krevn\u00EDho tlaku u pacient\u016F s rezistentn\u00ED hypertenz\u00ED. Do multicentrick\u00E9, dvojit\u011B zaslepen\u00E9, placebem kontrolovan\u00E9 studie ASPIRANT byli za\u0159azov\u00E1ni pacienti se systolick\u00FDm krevn\u00EDm tlakem v ordinaci >140 mmHg nebo diastolick\u00FDm TK >90 mmHg p\u0159es l\u00E9\u010Dbu minim\u00E1ln\u011B t\u0159emi r\u016Fzn\u00FDmi antihypertenz\u00EDvy, v\u010Detn\u011B diuretika. 117 pacient\u016F bylo randomizov\u00E1no k u\u017E\u00EDv\u00E1n\u00ED spironolaktonu (n=59) nebo placeba (n=58) metodou prost\u00E9 randomizace. Na\u0161\u00EDm prim\u00E1rn\u00EDm c\u00EDlem bylo prok\u00E1zat statisticky v\u00FDznamn\u00FD rozd\u00EDl v poklesu pr\u016Fm\u011Brn\u00E9ho denn\u00EDho systolick\u00E9ho a diastolick\u00E9ho tlaku p\u0159i ambulantn\u00EDm monitorov\u00E1n\u00ED krevn\u00EDho tlaku po 8 t\u00FDdnech l\u00E9\u010Dby mezi skupinami u\u017E\u00EDvaj\u00EDc\u00EDmi spironolakton a placebo. Anal\u00FDza byla provedena s daty 111 pacient\u016F (55 ve spironolaktonov\u00E9 skupin\u011B a 56 v placebov\u00E9 skupin\u011B). Po 8 t\u00FDdnech byl rozd\u00EDl v poklesu pr\u016Fm\u011Brn\u00E9ho denn\u00EDho tlaku p\u0159i ambulantn\u00EDm monitorov\u00E1n\u00ED krevn\u00EDho tlaku mezi skupinami -5,4 mmHg (95% CI -10,0;-0,8) pro systolick\u00FD (p=0,024) a -1,0 mmHg (95% CI-4,0; 2,0) pro diastolick\u00FD krevn\u00ED tlak (p=0,358). Hodnoty no\u010Dn\u00EDho systolick\u00E9ho krevn\u00EDho tlaku p\u0159i ambulantn\u00EDm monitorov\u00E1n\u00ED krevn\u00EDho tlaku, 24hodinov\u00E9ho ambulantn\u00EDho monitorov\u00E1n\u00ED krevn\u00EDho tlaku a krevn\u00EDho tlaku v ordinaci byly spironolaktonem v\u00FDznamn\u011B sn\u00ED\u017Eeny (rozd\u00EDl -8,6, -9,8 a -6,5 mmHg; p=0,011, 0,004 a 0,011), zat\u00EDmco pokles hodnot diastolick\u00E9ho kevn\u00EDho tlaku p\u0159i t\u011Bchto m\u011B\u0159en\u00EDch nebyl statisticky v\u00FDznamn\u00FD (-3,0, -1,0 a -2,5 mmHg; p=0,079, 0,405 a 0,079). Jedin\u00FD laboratorn\u00ED parametr, kter\u00FD predikoval pokles krevn\u00EDho tlaku po 8 t\u00FDdnech l\u00E9\u010Dby spironolaktonem, byl pom\u011Br aldosteron/plazmatick\u00E1 reninov\u00E1 aktivita na po\u010D\u00E1tku l\u00E9\u010Dby. V\u00FDskyt ne\u017E\u00E1douc\u00EDhc \u00FA\u010Dink\u016F byl v obou skupin\u00E1ch srovnateln\u00FD. Spironolakton vedl k v\u00FDznamn\u011Bj\u0161\u00EDmu poklesu systolick\u00E9ho t..." . "V sou\u010Dasnosti existuje m\u00E1lo dat o tom, kter\u00FD l\u00E9k by m\u011Bl b\u00FDt pou\u017Eit ke kontrole tlaku u pacient\u016F s rezistentn\u00ED arteri\u00E1ln\u00ED hypertenz\u00ED. V observa\u010Dn\u00EDch studi\u00EDch se v posledn\u00ED dob\u011B ukazuje jako \u00FA\u010Dinn\u00FD l\u00E9k spironolakton. Tato studie byla iniciov\u00E1na ke zhodnocen\u00ED \u00FA\u010Dinku spironolaktonu na sn\u00ED\u017Een\u00ED krevn\u00EDho tlaku u pacient\u016F s rezistentn\u00ED hypertenz\u00ED. Do multicentrick\u00E9, dvojit\u011B zaslepen\u00E9, placebem kontrolovan\u00E9 studie ASPIRANT byli za\u0159azov\u00E1ni pacienti se systolick\u00FDm krevn\u00EDm tlakem v ordinaci >140 mmHg nebo diastolick\u00FDm TK >90 mmHg p\u0159es l\u00E9\u010Dbu minim\u00E1ln\u011B t\u0159emi r\u016Fzn\u00FDmi antihypertenz\u00EDvy, v\u010Detn\u011B diuretika. 117 pacient\u016F bylo randomizov\u00E1no k u\u017E\u00EDv\u00E1n\u00ED spironolaktonu (n=59) nebo placeba (n=58) metodou prost\u00E9 randomizace. Na\u0161\u00EDm prim\u00E1rn\u00EDm c\u00EDlem bylo prok\u00E1zat statisticky v\u00FDznamn\u00FD rozd\u00EDl v poklesu pr\u016Fm\u011Brn\u00E9ho denn\u00EDho systolick\u00E9ho a diastolick\u00E9ho tlaku p\u0159i ambulantn\u00EDm monitorov\u00E1n\u00ED krevn\u00EDho tlaku po 8 t\u00FDdnech l\u00E9\u010Dby mezi skupinami u\u017E\u00EDvaj\u00EDc\u00EDmi spironolakton a placebo. Anal\u00FDza byla provedena s daty 111 pacient\u016F (55 ve spironolaktonov\u00E9 skupin\u011B a 56 v placebov\u00E9 skupin\u011B). Po 8 t\u00FDdnech byl rozd\u00EDl v poklesu pr\u016Fm\u011Brn\u00E9ho denn\u00EDho tlaku p\u0159i ambulantn\u00EDm monitorov\u00E1n\u00ED krevn\u00EDho tlaku mezi skupinami -5,4 mmHg (95% CI -10,0;-0,8) pro systolick\u00FD (p=0,024) a -1,0 mmHg (95% CI-4,0; 2,0) pro diastolick\u00FD krevn\u00ED tlak (p=0,358). Hodnoty no\u010Dn\u00EDho systolick\u00E9ho krevn\u00EDho tlaku p\u0159i ambulantn\u00EDm monitorov\u00E1n\u00ED krevn\u00EDho tlaku, 24hodinov\u00E9ho ambulantn\u00EDho monitorov\u00E1n\u00ED krevn\u00EDho tlaku a krevn\u00EDho tlaku v ordinaci byly spironolaktonem v\u00FDznamn\u011B sn\u00ED\u017Eeny (rozd\u00EDl -8,6, -9,8 a -6,5 mmHg; p=0,011, 0,004 a 0,011), zat\u00EDmco pokles hodnot diastolick\u00E9ho kevn\u00EDho tlaku p\u0159i t\u011Bchto m\u011B\u0159en\u00EDch nebyl statisticky v\u00FDznamn\u00FD (-3,0, -1,0 a -2,5 mmHg; p=0,079, 0,405 a 0,079). Jedin\u00FD laboratorn\u00ED parametr, kter\u00FD predikoval pokles krevn\u00EDho tlaku po 8 t\u00FDdnech l\u00E9\u010Dby spironolaktonem, byl pom\u011Br aldosteron/plazmatick\u00E1 reninov\u00E1 aktivita na po\u010D\u00E1tku l\u00E9\u010Dby. V\u00FDskyt ne\u017E\u00E1douc\u00EDhc \u00FA\u010Dink\u016F byl v obou skupin\u00E1ch srovnateln\u00FD. Spironolakton vedl k v\u00FDznamn\u011Bj\u0161\u00EDmu poklesu systolick\u00E9ho t..."@cs . . "Navr\u00E1til, K." . "146706" . "Spironolactone treatment in patients with resistant arterial hypertension (ASPIRANT): randomised, double blind, placebo controlled study"@en . "Hus\u00E1r, R." . "L\u00E9\u010Dba spironolaktonem u pacient\u016F s rezistentn\u00ED arteri\u00E1ln\u00ED hypertenz\u00ED (studie ASPIRANT)" . . . . "V\u00E1clav\u00EDk, T." . "7"^^ . . "Postgradu\u00E1ln\u00ED medic\u00EDna" . . . . "1"^^ . "Pl\u00E1\u0161ek, Ji\u0159\u00ED" . . "Jarkovsk\u00FD, J." . . . . "RIV/00843989:_____/12:00102515" . "L\u00E9\u010Dba spironolaktonem u pacient\u016F s rezistentn\u00ED arteri\u00E1ln\u00ED hypertenz\u00ED (studie ASPIRANT)"@cs . "Sedl\u00E1k, R." . "CZ - \u010Cesk\u00E1 republika" . "V\u00E1clav\u00EDk, J." . "14" . "[EFE984DA6EFD]" . "L\u00E9\u010Dba spironolaktonem u pacient\u016F s rezistentn\u00ED arteri\u00E1ln\u00ED hypertenz\u00ED (studie ASPIRANT)" . . "Koci\u00E1nov\u00E1, E." . "10"^^ . "T\u00E1borsk\u00FD, M." .