Spironolactone reduces brachial pulse wave velocity and PIIINP levels in hypertensive diabetic patients


Justine Davies, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee, UK. Email: j.i.davies@dundee.ac.uk



To assess whether spironolactone has beneficial effects on blood pressure (BP), N-terminal propeptide of type III procollagen (PIIINP) and pulse wave velocity (PWV) in hypertensive, type II diabetics.


Ten patients with type II diabetes and hypertension were enrolled in a randomized, double-blind crossover study comparing 4 months’ treatment with spironolactone and placebo with a 4-week washout phase. BP, PIIINP and carotid-radial PWV were measured at the end of each treatment phase.


Compared with placebo, spironolactone reduced systolic BP by 15.6 ± 46.1 mmHg (P = 0.005, 95% CI 2.7–28.5 mmHg), PIIINP by 0.6 ± 0.3 µg l−1 (P = 0.04, 95% CI 0.02–1.1 µg l−1) and PWV by 0.6 ± 0.2 m s−1 (P = 0.008, 95% CI 0.18–1.02 m s−1).


Spironolactone is effective at reducing systolic BP and brachial artery stiffness as indicated by PWV. It also reduces PIIINP in type II diabetic patients with hypertension.