Efficacy of Spironolactone Combined With Antihypertensive Drugs in Patients With Primary Aldosteronism
Third Military Medical University
350 participants
May 1, 2022
OBSERVATIONAL
Conditions
Summary
The goal of this observational study is to learn about the optimal dose of spironolactone treatment and the long-term outcomes on cardiovascular and cerebrovascular events in patients with lateralized PA who are unwilling to undergo surgery. The main question it aims to answer is: 1. What is the long-term effect of spironolactone treatment for lateralized PA? 2. What is the optimal dose of spironolactone treatment for the relief of renin inhibition in patients with lateralized PA? Participants will receive spironolactone treatment as part of their regular medical care for more than 12 months, and their clinical indicators, including blood pressure, biochemical remission, cardiovascular and renal damage, and the incidence of cardiovascular and cerebrovascular events, will be analyzed.
Eligibility
Inclusion Criteria4
- Male or female, aged 30\~65 years.
- PA patients with positive screening tests and saline suppression tests, and with AVS to determine lateralization. These patients have hypertension defined as office blood pressure ≥ 140/90 mmHg, or 24-hour ambulatory blood pressure showing average ≥ 130/80 mmHg, daytime blood pressure ≥ 135/85 mmHg, or nighttime blood pressure ≥ 120/70 mmHg.
- Patients with unilateral aldosterone-producing adenoma who decline surgery, or patients with non-adenoma, unilateral PA confirmed by AVS and meeting the above PA-related hypertension criteria.
- Provision of written informed consent to participate in the study.
Exclusion Criteria11
- Hyperkalemia.
- Renal impairment or have history of renal disease: serum creatinine \> 1.5 × upper limit of normal (ULN), dialysis, or nephrotic syndrome.
- Other confirmed secondary hypertension: pheochromocytoma, Cushing's syndrome, thyroid disorders, parathyroid disorders, acromegaly, renovascular disease, aortic disorders, chronic alcoholism, or drug dependence, etc.
- Adrenal insufficiency.
- Heart failure with NYHA class II-IV or stroke.
- Acute infection, malignancy, severe arrhythmia, psychiatric disorders, or drug/alcohol abuse.
- Significant hepatic dysfunction or have history of liver disease: AST or ALT \> 2 × ULN, cirrhosis, hepatic encephalopathy, esophageal varices or portosystemic shunt.
- Pregnancy or lactation.
- Participation in another clinical trial within the past 3 months.
- Inability to complete follow-up.
- Refusal to provide informed consent.
Interventions
The patients receive spironolactone treatment based on their conditions
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT07137364