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

NCT ID: NCT01062763

Last Updated: 2014-05-08

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

119 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-03-31

Study Completion Date

2012-05-31

Brief Summary

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

Detailed Description

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The primary object of the study is to estimate the effect of addition of low dose spironolactone to antihypertensive treatment with at least three antihypertensive drugs in patients with type-2 diabetes and blood pressure over 130/80 mmHg.

Secondary aims are to estimate how many of these patients have their blood pressure controlled by the addition of spironolactone, to investigate whether the addition of spironolactone affects insulin sensitivity and urinary protein secretion and to estimate the incidence of adverse effects of the aldosterone antagonist.

Conditions

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Arterial Hypertension Hypertension, Resistant to Conventional Therapy Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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addition of spironolactone

spironolactone is added to previous antihypertensive treatment

Group Type EXPERIMENTAL

spironolactone

Intervention Type DRUG

25 to 50 mg once daily

Placebo

Addition of placebo

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

addition of placebo 1 to 2 tablets daily

Interventions

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spironolactone

25 to 50 mg once daily

Intervention Type DRUG

placebo

addition of placebo 1 to 2 tablets daily

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age \< 75 years
* Type-2 diabetes
* Therapy resistant hypertension (by ABPM)
* Treatment with at least 3 antihypertensives

Exclusion Criteria

* HbA1c \> 10.0
* BP \> 180/110 mmHg
* Secondary hypertension
* Intolerance to spironolactone
* Permanent treatment with nonsteroidal antiinflammatory drugs or systemic glucocorticoids
* Total cholesterol 10 mmol/l
* New York Heart Association class III and IV
* Pregnancy or planned pregnancy
* Psychiatric disease
* Malignant disease
* Insufficient adherence
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ib Abildgaard Jacobsen

OTHER

Sponsor Role lead

Responsible Party

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Ib Abildgaard Jacobsen

Consultant physician, associate professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Ib A Jacobsen, DMSc

Role: PRINCIPAL_INVESTIGATOR

Odense University Hospital

References

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Elliott HL, Elawad M, Wilkinson R, Singh SP. Persistence of antihypertensive efficacy after missed doses: comparison of amlodipine and nifedipine gastrointestinal therapeutic system. J Hypertens. 2002 Feb;20(2):333-8. doi: 10.1097/00004872-200202000-00025.

Reference Type BACKGROUND
PMID: 11821720 (View on PubMed)

Nishizaka MK, Zaman MA, Calhoun DA. Efficacy of low-dose spironolactone in subjects with resistant hypertension. Am J Hypertens. 2003 Nov;16(11 Pt 1):925-30. doi: 10.1016/s0895-7061(03)01032-x.

Reference Type BACKGROUND
PMID: 14573330 (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)

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)

Chung EY, Ruospo M, Natale P, Bolignano D, Navaneethan SD, Palmer SC, Strippoli GF. Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease. Cochrane Database Syst Rev. 2020 Oct 27;10(10):CD007004. doi: 10.1002/14651858.CD007004.pub4.

Reference Type DERIVED
PMID: 33107592 (View on PubMed)

Oxlund CS, Cangemi C, Henriksen JE, Jacobsen IA, Gram J, Schousboe K, Tarnow L, Argraves WS, Rasmussen LM. Low-dose spironolactone reduces plasma fibulin-1 levels in patients with type 2 diabetes and resistant hypertension. J Hum Hypertens. 2015 Jan;29(1):28-32. doi: 10.1038/jhh.2014.27. Epub 2014 Apr 17.

Reference Type DERIVED
PMID: 24739800 (View on PubMed)

Other Identifiers

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2009-017033-22

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

EudraCT 2009-017033-22

Identifier Type: -

Identifier Source: org_study_id

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