The Efficacy of Spironolactone in Patients With Resistant Hypertension
NCT ID: NCT00430794
Last Updated: 2010-12-06
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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TERMINATED
PHASE2
40 participants
INTERVENTIONAL
2007-03-31
2008-12-31
Brief Summary
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Detailed Description
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Background and Rationale: The proportion of hypertensive patients meeting the definition of resistant hypertension is growing rapidly as doctors use more combination antihypertensive treatments in order to reach lower target blood pressures. Spironolactone is often used in specialist clinics for patients with resistant hypertension although it is currently only licensed in the UK for use in hypertension complicated by primary hyperaldosteronism. Uncontrolled studies suggest that spironolactone is a very effective antihypertensive in the modern management of resistant hypertension but we could find no randomised trials in this setting. In the Sheffield Hypertension Clinic spironolactone is currently used as one of the drugs of choice in patients with resistant hypertension, particularly in women and is anecdotally often very effective.
Study methods. The study will be a double- blind randomised placebo controlled trial with a parallel group design assessing the addition of 25mg spironolactone to existing antihypertensive treatment, titrated to 50mg if necessary in 40 patients with resistant hypertension (20 patients per group) over a period of 6 weeks. Resistant hypertension will be defined as: blood pressures not adequately controlled (systolic blood pressure (SBP) \>140 mmHg and/or diastolic blood pressure (DBP) \>85 mmHg in clinic and on ambulatory blood pressure monitoring) despite treatment with the maximum tolerated dose of three antihypertensive agents. All patients' current antihypertensive treatment will include a thiazide diuretic and at least one of a beta-blocker, angiotensin converting enzyme inhibitor or angiotensin II receptor antagonist. The primary endpoint will be the difference between the spironolactone and placebo groups in change in daytime average systolic blood pressure on 24-hour ambulatory blood pressure monitoring from day 0 to day 42.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Interventions
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Spironolactone
Eligibility Criteria
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Inclusion Criteria
* Hypertension (essential or secondary) managed in Sheffield Hypertension Clinic or general practice or both.
* Blood pressures not adequately controlled (systolic blood pressure (SBP) \>140 mmHg and/or diastolic blood pressure (DBP) \>85 mmHg in clinic and on ambulatory blood pressure monitoring) despite treatment with the maximum tolerated dose of three antihypertensive agents.
* Additional antihypertensive treatment deemed appropriate by the patients' doctor.
* Patients' current antihypertensive treatment includes a thiazide diuretic and at least one of a beta-blocker, angiotensin converting enzyme inhibitor or angiotensin II receptor antagonist.
Exclusion Criteria
* Known Conn's syndrome (definite indication for spironolactone)
* Heart failure NYHA class III or IV (definite indication for spironolactone)
* Known hepatic failure or significant cirrhosis
* Known pregnancy or women planning pregnancy
* Women of child bearing potential not using adequate contraceptive methods
* Serum creatinine \> 221µmol/l
* Serum Potassium \> 5.0mmol/l
* Clinic blood pressure or daytime ambulatory blood pressure \>240/120
18 Years
ALL
No
Sponsors
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University of Sheffield
OTHER
Sheffield Teaching Hospitals NHS Foundation Trust
OTHER
Principal Investigators
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Peter R Jackson, MB ChB, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Sheffield
Locations
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Clinical Research Facility, Royal Hallamshire Hospital
Sheffield, South Yorkshire, United Kingdom
Countries
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Other Identifiers
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STH14399
Identifier Type: -
Identifier Source: org_study_id