Spironolactone Treatment for Dermatologic Conditions and Blood Pressure Changes in Hypertensive Patients on Concomitant Antihypertensive Therapy

    July 2025 in “ Journal of Investigative Dermatology ”
    R.V. Paul Chan, Zachary J K Neubauer, Michael Ong, Karen A. Chernoff, Shari R. Lipner
    TLDR Spironolactone can safely lower blood pressure in patients on other blood pressure medications, but may slightly increase the risk of low blood pressure.
    This study analyzed 753 hypertensive patients using spironolactone for dermatologic conditions alongside antihypertensive therapy. Results showed a significant decrease in mean systolic and diastolic blood pressures (134 to 130 mmHg and 82 to 79 mmHg, respectively; P<0.001) across various antihypertensive classes, with a slight increase in hypotension diagnoses by 1.5%. The study found that spironolactone is generally safe for patients on antihypertensives, though those with low baseline BP or on multiple BP medications may have a higher risk of hypotension. The study suggests collaboration with primary care physicians and regular BP monitoring for these patients. Limitations include its retrospective design and lack of dose-response analysis.
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