In Resistant Hypertension, Is Spironolactone or Clonidine a Better Choice for a Fourth Drug?

The two drugs performed similarly, but spironolactone might be an easier medication to add.

Resistant hypertension is an infrequent but difficult-to-manage clinical problem. After prescription of the common frontline drugs (diuretic, angiotensin-converting–enzyme inhibitor or angiotensin-receptor blocker, and calcium-channel blocker), the most suitable drug to add is uncertain. In the ReHOT study (Resistant Hypertension Optimal Treatment), researchers in Brazil compared spironolactone and clonidine as a fourth drug in patients with resistant hypertension.

In the two-phase study, 1597 hypertensive patients were treated with ≤3 drugs for 12 weeks, and 187 patients (11.7%) were identified as having resistant hypertension. Compared with the other patients, those with true resistant hypertension had higher incidences of stroke and diabe…

Reviewing Author

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

Joel M. Gore, MD

Disclosures

Grant/Research SupportNIH–National Heart, Lung, and Blood Institute

In Resistant Hypertension, Is Spironolactone or Clonidine a Better Choice for a Fourth Drug?

Topics

Reviewing Author