Summary
The effect of adding spironolactone (Aldactone) on muscle electrolytes was studied in 48 patients with arterial hypertension and/or congestive heart failure who had received conventional diuretic treatment, including a potassium supplement, for more than 1 year. After 6 months on spironolactone 100 mg/day as well as the original conventional diuretic therapy, there was a significant increase in both skeletal muscle potassium and magnesium. At the same time these parameters decreased in the control group. In the spironolactone group there was also a significant increase in the mean serum potassium and creatinine levels. There was a significant fall in blood pressure in the spironolactone-treated group.
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Bergström J (1962) Muscle electrolytes in man determined by neutron activation analysis on needle biopsy specimens. A study on normal subjects, kidney patients, and patients with chronic diarrhoea. Scand J Clin Lab Invest 68 [Suppl]: 1–110
Bergström J, Hultman E, Solheim SB (1973) The effect of mefruside on plasma and muscle electrolytes and blood pressure in normal subjects and in patients with essential hypertension. Acta Med Scand 194: 417–433a
Bevegård S, Castenfors J, Danielsson M (1977) The effects of four months' treatment with spironolactone on systemic blood pressure, cardiac output and plasma renin activity in hypertensive patients. Acta Med Scand 202: 373–377
Bolte HD, Riecker G, Röhl D (1963) Messungen des Membranpotentials an einzelnen quergestreiften Muskelzellen der Menschen in situ. Klin Wochenschr 41: 356–359
Conway EJ (1957) Nature and significance of concentration solutions of potassium and sodium ions in skeletal muscle. Phys Rev 37: 84–132
Devane J, Ryan MP (1981) The effects of amiloride and triameterene on urinary magnesium excretion in conscious saline-loaded rats. Br J Pharmacol 72: 285–289
Dyckner T, Wester PO (1979) Ventricular extrasystoles and intracellular electrolytes before and after potassium and magnesium infusions in patients on diuretic treatment. Am Heart J 97: 12–18
Dyckner T, Wester PO (1983) Effect of magnesium on blood pressure. Br Med J 286: 1847–1849
Eisenman AJ, MacKenzie LB, Peters JP (1936) Protein and water of serum and cells of human blood, with a note on the measurement of red blood cell volume. J Biol Chem 116: 33–45
Graham JA, Lamb JF, Linton AL (1967) Measurement of body water and intracellular electrolytes by means of muscle biopsy. Lancet 2: 1172–1176
Helgeland A (1980) Treatment of mild hypertension: A five year controlled drug trial. The Oslo Study. Am J Med 69: 725–732
Horton R, Biglieri EG (1962) Effect of aldosterone on the metabolism of magnesium. J Clin Endocrin Metab 22: 1187–1192
Hypertension Detection and Follow-up Program Cooperative Group (1984) The effect of antihypertensive drug treatment on mortality in the presence of resting ECG abnormality. 10th Scientific Meeting. International Society of Hypertension, Interlaken. Abstract in the book of communications, no. 131
Hänze S, Seyberth H (1967) Untersuchungen zur Wirkung der Diuretika, Furosemid, Etacrynsäure und Triamteren auf die renale Magnesium- und Calciumausscheidung. Klin Wochenschr 43: 313–314
Lim P, Jacob E (1978) Magnesium-saving property of an aldosterone-antagonist in the treatment of oedema of liver cirrhosis. Br Med J 1: 755–756
MacGregor GA, Smith SJ, Markandu ND, Banks RA, Sagnella GA (1982) Moderate potassium supplementation in essential hypertension. Lancet 2: 567–570
Multiple Risk Factor Intervention Trial Research Group (1982) Multiple risk factor changes and mortality results. Am Med Assoc 248: 1465–1477
Neale TJ, Lynn KL, Bailey RR (1976) Spironolactone-associated aggravation of renal functional impairment. N Z Med J 83: 147–149
Skou JC (1957) The influence of some cations on an adenosine-triphosphatase from peripheral nerves. Biochim Biophys Acta 23: 394–401
Whang R, Welt RG (1963) Observations in experimental magnesium depletion. J Clin Invest 42: 305–313
Wheeler PG, Smith T, Golindano C, et al. (1977) Potassium and magnesium depletion in patients with cirrhosis on maintenance diuretic regimes. Gut 18: 683–687
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Dyckner, T., Wester, PO. & Widman, L. Effects of spironolactone on serum and muscle electrolytes in patients on long-term diuretic therapy for congestive heart failure and/or arterial hypertension. Eur J Clin Pharmacol 30, 535–540 (1986). https://doi.org/10.1007/BF00542411
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DOI: https://doi.org/10.1007/BF00542411