Situation: A patient with resistant hypertension developed CVA.
Reaction: Oh my God! Why was spironolactone not added?
Lesson: Make sure to add aldosterone antagonists for resistant hypertension. In an unblinded crossover trial, spironolactone was associated with a significantly greater fall in ambulatory and office blood pressure compared with dual angiotensin blockade among patients with resistant hypertension (J Hypertens 2010;28(11):2329–25).
Reaction: Oh my God! Why was spironolactone not added?
Lesson: Make sure to add aldosterone antagonists for resistant hypertension. In an unblinded crossover trial, spironolactone was associated with a significantly greater fall in ambulatory and office blood pressure compared with dual angiotensin blockade among patients with resistant hypertension (J Hypertens 2010;28(11):2329–25).
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