title: Racial differences in potassium response to spironolactone in heart failure.
abstract: Evidence of racial differences in aldosterone concentrations and K+ disposition suggests that response to aldosterone antagonism might vary by race. The authors sought to determine whether K+ response to spironolactone differs between African Americans and Caucasians with heart failure. Heart failure patients of African-American (n = 34) or Caucasian (n = 17) race were started on spironolactone 12.5 mg/d, with up-titration as tolerated. Laboratory values and drug therapy were similar between racial groups at baseline. Spironolactone was titrated to a median dose of 25 mg/d in both groups. Neither concomitant medications nor serum creatinine changed significantly in either group during spironolactone dose titration. Median serum K+ concentrations increased by 0.5 mEq/L (range, -0.7 to 1.6 mEq/L) in Caucasians, but only 0.1 mEq/L (range, -0.8 to 0.9 mEq/L) in African Americans; p < 0.01. These data suggest that African Americans with heart failure may be less responsive to the renal effects of spironolactone.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612-7230, USA. humma@uic.edu
authors.forename: Larisa H
authors.initials: LH
authors.lastname: Cavallari
authors.forename: Vicki L
authors.initials: VL
authors.lastname: Groo
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Momary
authors.forename: Deidra
authors.initials: D
authors.lastname: Fontana
authors.forename: Marlos Ag
authors.initials: MA
authors.lastname: Viana
authors.forename: Paul
authors.initials: P
authors.lastname: Vaitkus
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D011188:Potassium / Q000097:blood*; D013148:Spironolactone / Q000494:pharmacology* / Q000627:therapeutic use; D044465:White People
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D011188:Potassium