Key result
Spironolactone yields a ~20-percentage-point higher BP target achievement rate in resistant hypertension.
Why the study?
The clinical efficacy and safety of combination drug regimens for patients with resistant hypertension needed evaluation.
Does adding spironolactone 20 mg daily to conventional triple antihypertensive therapy improve blood pressure reduction and control rates in patients with resistant hypertension?
RCT (n=90)
Random number table method
No
Does adding spironolactone 20 mg daily to conventional triple antihypertensive therapy improve blood pressure reduction and control rates in patients with resistant hypertension?
Absolute Event Rate: 82.2% vs 62.2%
p-value: p=0.034
Adding low-dose spironolactone to standard triple antihypertensive therapy safely and effectively improves blood pressure reduction and target attainment in patients with resistant hypertension.
May support spironolactone addition in resistant hypertension; leaves open confirmation in randomized trials.
目的：观察联合用药方案对顽固性高血压患者的临床疗效及安全性。方法：选取90例顽固性高血压患 者，随机分为观察组与对照组各45例。对照组给予常规三联降压治疗（血管紧张素转换酶抑制剂 钙通道阻滞剂 利尿 剂），观察组在对照组基础上加用螺内酯，两组疗程均为12周。比较两组治疗前后血压变化、血压达标率及不良反应 发生情况。结果：治疗后，观察组收缩压、舒张压降幅均显著大于对照组（p < 0.05）；观察组血压达标率为82.2%， 显著高于对照组的62.2%（p < 0.05）；两组不良反应发生率无显著差异（p > 0.05）。结论：在常规三联降压基础上 加用螺内酯的四联方案治疗顽固性高血压疗效确切、安全可靠，值得临床推广应用。
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唐姗姗 et al. (2026) conducted an RCT in Resistant hypertension (n=90). Spironolactone vs. Standard triple antihypertensive therapy (Benazepril + Nifedipine + Hydrochlorothiazide) was evaluated on Blood pressure target achievement rate (< 140/90mmHg) at 12 weeks (p=0.034).
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