This retrospective study evaluated the efficacy and safety of low-dose spironolactone in primary aldosteronism, showing that reduced doses may achieve adequate blood pressure and potassium control with fewer side effects.
BACKGROUND:Spironolactone is recommended as first-line therapy for patients with idiopathic primary aldosteronism. The aim of this study is to evaluate the impact of low and high doses of spironolactone on arterial blood pressure control, potassium levels, and the incidence of drug-related adverse effects.METHODS:We retrospectively included 394 patients with primary aldosteronism receiving spironolactone. Patients were divided into 2 groups, according to the median prescribed dose in our population (50 mg, 25–75): subjects treated with doses ≤50 mg versus >50 mg.RESULTS:The median follow-up after the introduction of spironolactone was 12 months, and 128 patients experienced adverse effects, with a proportion higher in men than in women (44.70% versus 15.70%). The most frequently reported adverse effect was gynecomastia, followed by sexual dysfunction. Subjects receiving a dose >50 mg of spironolactone displayed a higher prevalence of adverse effects (39.1%) compared to th
