Effect of low-dose spironolactone on resistant hypertension in type 2 diabetes mellitus: a randomized controlled trial in a sub-Saharan African population. (December 2016)

• Record Type: Journal Article
• Authors: Djoumessi, Romance; Noubiap, Jean; Kaze, Francois; Essouma, Mickael; Menanga, Alain; Kengne, Andre; Mbanya, Jean; Sobngwi, Eugene
• Is Part Of: BMC research notes. Volume 9:Number 1(2016)
• Page Start: 1
• Page End: 9
• Publication Date: 2016-12
• Subjects: Spironolactone -- Resistant hypertension -- Type 2 diabetes mellitus -- Sub-Saharan Africa -- Cameroon; Medicine -- Periodicals; Biology -- Periodicals; 610.5
• DOI: 10.1186/s13104-016-1987-5
• Languages: English
• ISSNs: 1756-0500

Abstract

Abstract Background Low-dose spironolactone has been proven to be effective for resistant hypertension in the general population, but this has yet to be confirmed in type 2 diabetic (T2DM) patients. We assessed the efficacy of a low-dose spironolactone on resistant hypertension in a sub-Saharan African population of T2DM patients from Cameroon. Methods This was a four-week single blinded randomized controlled trial in 17 subjects presenting with resistant hypertension in specialized diabetes care units in Cameroon. They were randomly assigned to treatment with a daily 25 mg of spironolactone (n = 9) or to an alternative antihypertensive regimen (n = 8), on top of any ongoing regimen and prevailing lifestyle prescriptions. They were seen at the start of the treatment, then 2 and 4 weeks later. The primary outcome was change in office and self-measured blood pressure (BP) during follow-up, and secondary outcomes were changes in serum potassium, sodium, and creatinine levels. Results Compared with alternative treatment, low-dose spironolactone was associated with significant decrease in office systolic BP (−33 vs. −14 mmHg;p = 0.024), and in diastolic BP (−14 vs. −5 mmHg;p = 0.006). After 1 month of spironolactone, all the patients were controlled based on BP below 130/80 mmHg, with significant office BP reduction from 158 ± 17/86 ± 11 to 125 ± 11/72 ± 8, vs. 158 ± 8/94 ± 8 to 144 ± 17/89 ± 12 mmHg in the alternative treatment group. There was no significant variation in sodium and creatinine levels in both groups, but a mild increase of potassium levels in the spironolactone group. Interpretation Add-on low-dose spironolactone was effective in reducing BP to optimal levels in T2DM Cameroonian patients despite mild increase in serum potassium. Trial registration ClinicalTrials.gov IdentifierNCT02426099 .Date of registration April 2015