Addition of Spironolactone in Patients With Resistant Arterial Hypertension

09:32 EST 23rd November 2014 | BioPortfolio

Summary

The purpose of this study is to evaluate the efficacy of spironolactone on lowering blood pressure when added to therapy in patients with resistant arterial hypertension.

Description

Arterial hypertension resistant to therapy and requiring treatment with more then three antihypertensive drugs is common. At present there are is no standard therapy for resistant hypertension based on randomised clinical trials, neither data to guide addition of further drugs to therapy. Recently some observational and retrospective trials reported good effect of spironolactone in patients with resistant hypertension, but these data were not validated by prospective randomised clinical trials.

This is a multicentric, randomised, double blind clinical trial, which will evaluate the effect of addition of 25 mg spironolactone to current medication compared to placebo. The study will enroll patients with blood pressure over 140/90 mmHg during a clinical examination, which are using at least three antihypertensive drugs, one of them being a diuretic. Average daytime systolic and diastolic blodd pressure will be evaluated by ABPM (ambulatory blood pressure monitoring).

Study Design

Allocation: Randomized, Control: Placebo Control, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment

Conditions

Hypertension

Intervention

spironolactone

Location

Olomouc University Hospital and Palacký University School of Medicine
Olomouc
Czech Republic
775 20

Status

Recruiting

Source

University Hospital Olomouc

Results (where available)

View Results

Links

Clinical Trials [611 Associated Clinical Trials listed on BioPortfolio]

Spironolactone Combined With Captopril and Carvedilol for the Treatment of Pulmonary Arterial Hypertension

The purpose of this study is to determine whether a larger dose of the aldosterone antagonist spironolactone combined with an ACE inhibitor (captopril) and a beta-blocker (carvedilol) is e...

Autoregulation of Glomerular Filtration Rate in Patients With Type 1 Diabetes During Spironolactone Therapy

To evaluate the impact of spironolactone treatment on renal autoregulation in hypertensive type 1 diabetic patients.

The Effect of Spironolactone on Blood Pressure in Type-2 Diabetics With Resistant Hypertension

The purpose of this study is to estimate the effect of spironolactone on blood pressure resistant to therapy in type-2 diabetics.

Importance of Aldosterone in the Pathogenesis of Hypertensive Heart Disease

The Renin-Angiotensin-Aldosterone-system is important in the development of cardiovascular organ damage caused by arterial hypertension. This study aims at evaluating the importance of ald...

Left Ventricular Hypertrophy and Spironolactone in End Stage Renal Disease

The hypothesis of this trial is to assess the effect of spironolactone on heart size and mass

PubMed Articles [2369 Associated PubMed Articles listed on BioPortfolio]

Effect of spironolactone on diabetic nephropathy compared to the combination of spironolactone and losartan.

Diabetic nephropathy is the most important cause of end stage renal disease (ESRD). Aldosterone is involved in renal damage through induction of fibrosis, inflammation and necrosis in the kidney tissu...

Aldosterone and Volume Management in Hypertensive Heart Disease.

Aldosterone-receptor antagonists dose-dependently reduce both the epithelial and nonepithelial actions of aldosterone. These compounds are used commonly in the treatment of hypertension, with or witho...

Resistant hypertension: a review of diagnosis and management.

Resistant hypertension-uncontrolled hypertension with 3 or more antihypertensive agents-is increasingly common in clinical practice. Clinicians should exclude pseudoresistant hypertension, which resul...

Comparison of spironolactone and trichlormethiazide as add-on therapy to renin-angiotensin blockade for reduction of albuminuria in diabetic patients.

To compare the efficacy of spironolactone and trichlormethiazide, as add-on therapy to renin-angiotensin system (RAS) blockade, for reduction of albuminuria in diabetic patients with chronic kidney di...

Aldosterone synthase inhibitors in hypertension: current status and future possibilities.

The renin-angiotensin aldosterone system is a critical mechanism for controlling blood pressure, and exerts most of its physiological effects through the action of angiotensin II. In addition to incre...

Medical and Biotech [MESH] Definitions

A condition in pregnant women with elevated systolic (>140 mm Hg) and diastolic (>90 mm Hg) blood pressure on at least two occasions 6 h apart. HYPERTENSION complicates 8-10% of all pregnancies, generally after 20 weeks of gestation. Gestational hypertension can be divided into several broad categories according to the complexity and associated symptoms, such as EDEMA; PROTEINURIA; SEIZURES; abnormalities in BLOOD COAGULATION and liver functions.

Hypertension due to RENAL ARTERY OBSTRUCTION or compression.

A potassium sparing diuretic that acts by antagonism of aldosterone in the distal renal tubules. It is used mainly in the treatment of refractory edema in patients with congestive heart failure, nephrotic syndrome, or hepatic cirrhosis. Its effects on the endocrine system are utilized in the treatments of hirsutism and acne but they can lead to adverse effects. (From Martindale, The Extra Pharmacopoeia, 30th ed, p827)

Increased pressure within the cranial vault. This may result from several conditions, including HYDROCEPHALUS; BRAIN EDEMA; intracranial masses; severe systemic HYPERTENSION; PSEUDOTUMOR CEREBRI; and other disorders.

A condition of markedly elevated BLOOD PRESSURE with DIASTOLIC PRESSURE usually greater than 120 mm Hg. Malignant hypertension is characterized by widespread vascular damage, PAPILLEDEMA, retinopathy, HYPERTENSIVE ENCEPHALOPATHY, and renal dysfunction.

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