Resistant hypertension optimal treatment trial: a randomized controlled trial
- PMID: 24338935
- PMCID: PMC6649632
- DOI: 10.1002/clc.22228
Resistant hypertension optimal treatment trial: a randomized controlled trial
Erratum in
- Clin Cardiol. 2014 Jun;37(6):388. Multiple investigator names added
Abstract
The prevalence of resistant hypertension (ReHy) is not well established. Furthermore, diuretics, angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, and calcium channel blockers are largely used as the first 3-drug combinations for treating ReHy. However, the fourth drug to be added to the triple regimen is still controversial and guided by empirical choices. We sought (1) to determine the prevalence of ReHy in patients with stage II hypertension; (2) to compare the effects of spironolactone vs clonidine, when added to the triple regimen; and (3) to evaluate the role of measuring sympathetic and renin-angiotensin-aldosterone activities in predicting blood pressure response to spironolactone or clonidine. The Resistant Hypertension Optimal Treatment (ReHOT) study (ClinicalTrials.gov NCT01643434) is a prospective, multicenter, randomized trial comprising 26 sites in Brazil. In step 1, 2000 patients will be treated according to hypertension guidelines for 12 weeks, to detect the prevalence of ReHy. Medical therapy adherence will be checked by pill count monitoring. In step 2, patients with confirmed ReHy will be randomized to an open label 3-month treatment with spironolactone (titrating dose, 12.5-50 mg once daily) or clonidine (titrating dose, 0.1-0.3 mg twice daily). The primary endpoint is the effective control of blood pressure after a 12-week randomized period of treatment. The ReHOT study will disseminate results about the prevalence of ReHy in stage II hypertension and the comparison of spironolactone vs clonidine for blood pressure control in patients with ReHy under 3-drug standard regimen.
© 2013 Wiley Periodicals, Inc.
Figures


References
-
- Butler RN. Living longer, contributing longer. JAMA. 1997;278:1372–1373. - PubMed
-
- Appel LJ. Dietary patterns and longevity: expanding the blue zones. Circulation. 2008;118:214–215. - PubMed
-
- Pedrosa RP, Drager LF, Gonzaga CC, et al. Obstructive sleep apnea: the most common secondary cause of hypertension associated with resistant hypertension. Hypertension. 2011;58:811–817. - PubMed
-
- Howard BV, Rodriguez BL, Bennett PH, et al. Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group I: epidemiology. Circulation. 2002;105:e132–e137. - PubMed
Publication types
MeSH terms
Substances
Associated data
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical