Daily blood pressure profile by adding spironolactone to standard two- component antihypertensive therapy

   Aim of research: to evaluate the dynamics of ambulatory blood pressure monitoring parameters in patients with arterial hypertension by adding spironolactone to standard antihypertensive therapy of calcium antagonist and angiotensin-converting enzyme inhibitor antihypertensive therapy.

   Materials and methods. 70 patients were randomized into two groups: the first group received of amlodipine/lisinopril combination, the second group followed the same regimen of therapy with addition of 25 mg/day of spironolactone. The monitoring period was 6 months. In all patients we studied and compared the dynamics of office blood pressure, ambulatory blood pressure monitoring parameters including morning blood pressure surge and morning blood pressure surge rate initially, through/peak ratio.

   Results. After of 24 weeks of treatment the office and daily average blood pressure decreased in both groups. Diastolic blood pressure decreased to a greater extent in the spironolactone supplementation group. In the spironolactone group, in distinction from the two-component therapy group, the morning blood pressure surge decreased on average by of 5,0 (-15,4; +2,4) mm Hg. In the standard therapy group, an increase in the morning blood pressure surge rate on average by of 3,1 (1,3; +16,4) mm Hg/h was noted, which was not observed in the spironolactone group. The mean final effect/peak effect ratio for systolic blood pressure became equal 43,5 (7,5; 71,0) % during two-component therapy and 69,0 (46; 89) % in the spironolactone group (p < 0,05).

   Conclusions: The addition of spironolactone to the standard two-component combination in patients with arterial hypertension leads to an additional decrease in office and average daily diastolic blood pressure, reduction of morning blood pressure rise and increase of the antihypertensive effect uniformity in the form of an increase in the final effect/peak effect ratio.

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