Combination Application of Low-Dose Hydrochlorothiazide and Spironolactone in the Treatment of Refractory Hypertension

LI Dan

doi:10.3969/j.issn.1672-7185.2024.04.006

Abstract：Objective To explore the therapeutic effect of low-dose hydrochlorothiazide and spironolactone on patients with refractory hypertension(RH).Methods A total of 80 RH patients admitted to Liaoyang Central Hospital from January 2021 to December 2022 were randomly divided into a control group and an observation group,with 40 cases in each group.The basic treatment drugs for all patients were nifedipine,irbesartan,and prazosin.The control group chose low-dose hydrochlorothiazide as the diuretic,while the observation group added a small dose of spironolactone on top of it.The changes in cardiac load,cardiac structure,and laboratory indicators between two groups after treatment were compared.Results After 2 weeks of treatment,the systolic and diastolic blood pressure in the observation group were significantly lower than those in the control group(P<0.05).However,there was no significant difference in heart rate between the two groups(P>0.05).After 12 weeks of treatment,the left atrial diameter in the observation group was significantly smaller than that in the control group(P<0.05).However,there was no significant difference in left ventricular diameter and interventricular septum thickness between the two groups(P>0.05).After 4 weeks of treatment,there was no significant difference in the levels of alanine aminotransferase,aspartate aminotransferase,urea nitrogen,creatinine,blood potassium,triglycerides,and total cholesterol between the two groups(P>0.05).Conclusion Low dose hydrochlorothiazide and spironolactone can further reduce cardiac compliance,improve myocardial remodeling,and have no significant impact on liver function,kidney function,and blood lipids in the treatment of RH patients.