Spironolactone treatment for dermatologic indications is not associated with hypotension in a single-center retrospective study

    March 2024 in “ Journal of the American Academy of Dermatology ”
    Rachel C. Hill, Yu Wang, Bilal Shaikh, Michael Ong, Paul J. Christos, Shari R. Lipner
    TLDR Spironolactone for skin issues rarely causes low blood pressure.
    A retrospective study involving 1,173 women taking spironolactone for dermatologic conditions such as acne, hair loss, and hirsutism found that only 3.1% experienced absolute hypotension, and just 0.26% required a change in therapy due to hypotension. The study concluded that age, race, ethnicity, and maximum daily dose were not reliable predictors of hypotension risk. There were no significant changes in mean systolic or diastolic blood pressure associated with spironolactone use. The authors suggest that while baseline blood pressure should be measured before starting spironolactone, continuous blood pressure monitoring may not be necessary unless orthostatic symptoms are present. Further prospective studies are recommended to confirm these findings.
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