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Easing resistant blood pressure

Hypertension, present in 80% of people with type 2 diabetes, is a rising problem worldwide. Although there at least eleven different classes of blood pressure lowering medications, around 25% of people treated will have resistant hypertension, defined as a blood pressure above target despite treatment with 3 medications, or a blood pressure at target treated with 4 or more medications. This current study supports others in showing that spironolactone is particularly effective in people with resistant hypertension, perhaps because of aldosterone escape, which can occur after prolonged renin-angiotensin system blockade. This is supported by their finding that spironolactone effectiveness was inversely related to plasma renin.

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