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 onc...Continue Reading
References
Jan 12, 1979·JAMA : the Journal of the American Medical Association·J H LaraghT G Pickering
Jul 1, 1977·The American Journal of Cardiology·A Zweifler, M Esler
Nov 1, 1995·The American Journal of Cardiology·D LiaoG Heiss
Oct 29, 1997·JAMA : the Journal of the American Medical Association·R N Butler
Oct 3, 1999·Annals of Internal Medicine·N C NetzerK P Strohl
May 8, 2002·Circulation·Barbara V HowardJudith Wylie-Rosett
May 23, 2002·Hypertension·Sandra J TalerJo Ellen Augustine
Sep 3, 2002·Journal of the American College of Cardiology·Harlan M KrumholzA David Paltiel
Dec 20, 2002·JAMA : the Journal of the American Medical Association·UNKNOWN ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatm
Nov 1, 2005·Lancet·Lars Hjalmar LindholmOla Samuelsson
Feb 21, 2007·Hypertension·Neil ChapmanUNKNOWN Anglo-Scandinavian Cardiac Outcomes Trial Investigators
Aug 10, 2007·Current Hypertension Reports·Dan Carl, Domenic A Sica
Dec 19, 2007·Hypertension·Eduardo PimentaDavid A Calhoun
Apr 9, 2008·Hypertension·David A CalhounRobert M Carey
Jun 25, 2008·Circulation·David A CalhounUNKNOWN American Heart Association Professional Education Committee
Jul 16, 2008·Circulation·Lawrence J Appel
Feb 25, 2009·Hypertension·Ross D FeldmanBrian G Feagan
Sep 4, 2009·Cleveland Clinic Journal of Medicine·Qi CheMohammed A Rafey
Oct 7, 2009·Circulation·K G M M AlbertiUNKNOWN International Association for the Study of Obesity
Apr 13, 2010·The American Journal of Cardiology·Luciano F DragerGeraldo Lorenzi-Filho
Aug 17, 2010·PloS One·Luciano F DragerGeraldo Lorenzi-Filho
Mar 30, 2011·Hypertension·Alejandro de la SierraLuis M Ruilope
Apr 20, 2011·Hypertension·Stephen D Persell
May 4, 2011·Hypertension·Jan VáclavíkMilos Táborsky
Aug 10, 2011·Circulation·Brent M EganKeith C Ferdinand
Oct 5, 2011·Hypertension·Rodrigo P PedrosaGeraldo Lorenzi-Filho
Mar 2, 2012·Circulation·Stacie L DaughertyP Michael Ho
Mar 2, 2012·Circulation·Eduardo Pimenta, David A Calhoun
Jun 26, 2012·Journal of Hypertension·Guillaume BobriePierre-François Plouin
Jul 13, 2012·Journal of Hypertension·Giuseppe Mancia
Citations
Oct 24, 2014·The Journal of Clinical Hypertension·Paulo A LotufoIsabela M Bensenor
Feb 9, 2017·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·E M RegoP L da Luz
Mar 30, 2017·Current Hypertension Reports·Hamish Cg ProsserMarkus P Schlaich
Nov 23, 2017·Clinical and Experimental Pharmacology & Physiology·José Luiz de Brito Alves, João Henrique Costa-Silva
May 18, 2018·Current Medical Research and Opinion·Carol A ForbesEmil Hagström
Feb 22, 2018·Hypertension·Eduardo M KriegerUNKNOWN ReHOT Investigators
Jun 18, 2018·Current Hypertension Reports·Andrea Pio-Abreu, Luciano F Drager
Feb 1, 2020·Scientific Reports·Carolina Tosin BuenoPaulo Caleb Junior Lima Santos
Jul 23, 2015·Current Hypertension Reports·Nihal El Rouby, Rhonda M Cooper-DeHoff
Nov 10, 2020·The Journal of Clinical Hypertension·Daniel de Oliveira BeraldoMarcelo C Batista