Common high blood pressure medication may reduce heart failure risk after heart attack, study finds

Recent research, published in the American Heart Journal and the New England Journal of Medicine, found that the high blood pressure medication spironolactone may reduce the risk of heart failure in people recovering from a heart attack. However, the medication did not significantly reduce the number of deaths or other severe heart-related events.

Spironolactone is a diuretic that blocks certain hormones. The medication is commonly prescribed for high blood pressure and other conditions, including edema (fluid retention that causes swelling), low potassium levels and heart failure.

The research comes from a trial of more than 7,000 adults in 14 countries who had experienced a severe heart attack. The trial participants who took spironolactone had a 31% lower risk of new or worsening heart failure than people in the study who did not take the medication.

The average age of the 7,062 participants was 60, and 20% of participants self-identified as women. In the study, 95% had experienced a severe heart attack known as ST elevation myocardial infarction (STEMI), and 18% had diabetes.

“While spironolactone didn’t reduce deaths or other major heart complications after a heart attack, it did reduce the likelihood of heart failure, which is an important finding for patients and health care professionals,” said Sanjit Jolly, M.D., M.Sc., lead author of the trial and a scientist at the Population Health Research Institute – a joint institute of McMaster University and Hamilton Health Sciences in Hamilton, Ontario, Canada.

“Participants fared much better in this trial than in previous ones. This reflects the advances in angioplasty techniques in the overall care for heart attacks. Modern treatment approaches, including medication, stent technology and more timely interventions, have positively impacted patient outcomes,” Jolly said.

One key study limitation that the research group highlighted was that women and people of different races and ethnicities were underrepresented in the participant pool. The results, therefore, may not be generalizable to the larger population.

More research is needed to further explore the potential for spironolactone to prevent heart failure and its long-term impact on an individual’s heart health after a heart attack.