Addition of Spironolactone in Patients With Resistant Arterial Hypertension

NCT ID: NCT00524615

Last Updated: 2012-06-20

Study Results

Results pending

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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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-09-30

Study Completion Date

2012-12-31

Brief Summary

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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.

Detailed Description

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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).

Conditions

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Hypertension

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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1

25 mg of Spironolactone oraly once daily

Group Type ACTIVE_COMPARATOR

spironolactone

Intervention Type DRUG

25 mg of spironolactone once daily or placebo for 2 months

2

placebo oraly once daily

Group Type PLACEBO_COMPARATOR

spironolactone

Intervention Type DRUG

25 mg of spironolactone once daily or placebo for 2 months

Interventions

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spironolactone

25 mg of spironolactone once daily or placebo for 2 months

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients over 18 years
* Resistant arterial hypertension: (blood pressure during clinical control exceeding 140/90 mmHg (or 130/80 mmHg in in diabetic patients or patients with renal disease with creatinine level of more than 133 μmol per liter or urinary protein excretion of more than 300 mg over a 24-hour period) despite adherence to treatment with full doses of at least three antihypertensive medications, including a diuretic

Exclusion Criteria

* Pregnant or breastfeeding women, women in fertile age without ruled out pregnancy
* Severe hypertension over 180/110 mmHg
* Renal insufficiency with creatinine over 180 umol/l or GFR lower than 40 ml/min
* Hyperkalemia over 5,4 mmol/l, hyponatremia below 130 mmol/l
* Porphyria
* Hypersensitivity to the compounds of Verospiron (Richter Gedeon, Hungary) drug
* Patients taking any aldosterone antagonist (spironolactone, eplerenone, kanreone)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Czech Society of Hypertension

OTHER

Sponsor Role collaborator

Prostejov Hospital

UNKNOWN

Sponsor Role collaborator

Brno University Hospital

OTHER

Sponsor Role collaborator

Olomouc Military Hospital

UNKNOWN

Sponsor Role collaborator

Gedeon Richter Ltd.

INDUSTRY

Sponsor Role collaborator

Jan Vaclavík

OTHER

Sponsor Role lead

Responsible Party

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Jan Vaclavík

Principal investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Jan Václavík, MD.

Role: STUDY_DIRECTOR

Internal medicine department I, Olomouc university hospital and Palacký University School of medicine

Bořek Lačňák, MD.

Role: PRINCIPAL_INVESTIGATOR

Internal Medicine Dept., Šternberk Hospital

Martin Plachý, MD.

Role: PRINCIPAL_INVESTIGATOR

Internal medicine department II, Brno University Hospital

Locations

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Olomouc University Hospital and Palacký University School of Medicine

Olomouc, , Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Jan Václavík, MD.

Role: CONTACT

+420588443209

Facility Contacts

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Jan Václavík, MD.

Role: primary

References

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Chapman N, Dobson J, Wilson S, Dahlof B, Sever PS, Wedel H, Poulter NR; Anglo-Scandinavian Cardiac Outcomes Trial Investigators. Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension. 2007 Apr;49(4):839-45. doi: 10.1161/01.HYP.0000259805.18468.8c. Epub 2007 Feb 19.

Reference Type BACKGROUND
PMID: 17309946 (View on PubMed)

Sharabi Y, Adler E, Shamis A, Nussinovitch N, Markovitz A, Grossman E. Efficacy of add-on aldosterone receptor blocker in uncontrolled hypertension. Am J Hypertens. 2006 Jul;19(7):750-5. doi: 10.1016/j.amjhyper.2005.11.016.

Reference Type BACKGROUND
PMID: 16814132 (View on PubMed)

Vaclavik J, Sedlak R, Jarkovsky J, Kocianova E, Taborsky M. Effect of spironolactone in resistant arterial hypertension: a randomized, double-blind, placebo-controlled trial (ASPIRANT-EXT). Medicine (Baltimore). 2014 Dec;93(27):e162. doi: 10.1097/MD.0000000000000162.

Reference Type DERIVED
PMID: 25501057 (View on PubMed)

Vaclavik J, Sedlak R, Plachy M, Navratil K, Plasek J, Husar R, Kocianova E, Taborsky M. Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT)--study protocol. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011 Jun;155(2):143-8. doi: 10.5507/bp.155.2011.004.

Reference Type DERIVED
PMID: 21804623 (View on PubMed)

Vaclavik J, Sedlak R, Plachy M, Navratil K, Plasek J, Jarkovsky J, Vaclavik T, Husar R, Kocianova E, Taborsky M. Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension. 2011 Jun;57(6):1069-75. doi: 10.1161/HYPERTENSIONAHA.111.169961. Epub 2011 May 2.

Reference Type DERIVED
PMID: 21536989 (View on PubMed)

Related Links

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http://www.lf.upol.cz/en/

Palacký University School of Medicine

http://www.fnol.cz/

Olomouc University Hospital

Other Identifiers

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EudraCT 2007-003558-27

Identifier Type: -

Identifier Source: secondary_id

ASPIRANT-1

Identifier Type: -

Identifier Source: org_study_id

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