What is Resistant Hypertension?
One in three American adults has high blood pressure or hypertension that can lead to serious cardiovascular conditions such as coronary artery disease, heart attack, abnormal heart rhythms, heart failure, heart valve disease, and vascular disease. Along with diet and exercise, patients can take control of high blood pressure by taking antihypertensive medications that safely lower blood pressure to prevent damage to vital arteries in the body.
Taking prescription medications as directed is one of the most important factors that can determine the effectiveness of certain treatments. In particular, the effectiveness of hypertension medications is dependent on lifestyle modifications like eating a low sodium diet, reducing alcohol consumption, and weight loss. One of the serious consequences of non-adherence to lifestyle modifications while taking blood pressure medication is the development of resistant hypertension, where one or three different hypertensive medications alone cannot control blood pressure in patients. Resistant hypertension significantly increases the risks for serious health complications in patients who have diabetes, are morbidly obese, have sleep apnea, and chronic kidney disease.
A recent clinical trial conducted by the University College London Hospitals National Institutes for Health Research found that resistant hypertension patients can control blood pressure by supplementing hypertensive medications with spironolactone, a medication typically used for heart failure. According to Renal & Urology News, lead researcher professor Bryan Williams, MD stated that with spironolactone, “almost 60% achieve blood pressure control within the first three months of use.”
Resistant Hypertension and Spironolactone
During the Pathway-2 clinical trial, patients with treatment-resistant hypertension were given spironolactone to supplement other maximum dosage blood pressure medications. The results of the clinical trial found that adding spironolactone significantly lowered blood pressure in patients with resistant hypertension, and is more effective than other add-on hypertensive medications like bisoprolol or doxazosin. The clinical trial also discovered that one of the causes of resistant hypertension is sodium retention, which causes blood pressure to rise.
The significance of this clinical trial gives physicians a more direct approach to treating patients with resistant hypertension, and establishes spironolactone as an effective way to manage hard to manage high blood pressure. The results of this trial will likely help establish future treatment guidelines for hypertension, and help patient information messaging that warns about the risks associated with non-adherence to lifestyle changes such as lowering sodium intake. Get more information about blood pressure medications on our Blood Pressure Condition Page.