Spironolactone and Hydrochlorothiazide Decrease Vascular Stiffness and Blood Pressure in Geriatric Hypertension
Article first published online: 1 JUN 2010
© 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 58, Issue 7, pages 1327–1332, July 2010
How to Cite
Kithas, P. A. and Supiano, M. A. (2010), Spironolactone and Hydrochlorothiazide Decrease Vascular Stiffness and Blood Pressure in Geriatric Hypertension. Journal of the American Geriatrics Society, 58: 1327–1332. doi: 10.1111/j.1532-5415.2010.02905.x
- Issue published online: 2 JUL 2010
- Article first published online: 1 JUN 2010
- pulse wave velocity;
- vascular stiffness;
- ambulatory blood pressure monitoring
OBJECTIVES: To determine the efficacy of spironolactone (SPIRO) and hydrochlorothiazide (HCTZ) as monotherapy in older patients with hypertension in blood pressure (BP) control and measures of vascular stiffness.
DESIGN: Randomized double-blind trial.
SETTING: University teaching hospital.
PARTICIPANTS: Forty-five subjects with hypertension (24 men, 21 women, mean age 69).
INTERVENTION: Six months of HCTZ (n=21) or SPIRO (n=24) therapy titrated to a target systolic BP (SBP) less than 140 mmHg.
MEASUREMENTS: Baseline (after 4 weeks of antihypertensive drug washout) and 6-month 24-hour ambulatory BP data were obtained. Pulse pressure (PP) was calculated as the difference between 24-hour average SBP and DBP. Pulse wave velocity (PWV) was determined according to noninvasive recordings of carotid and femoral artery pulse waves.
RESULTS: Six months of HCTZ and SPIRO treatment was associated with significant decreases in 24-hour and nocturnal SBP and diastolic BP (DBP) (analysis of variance (ANOVA) P<.001). At 6 months, average 24-hour and nocturnal SBP were lower in the SPIRO than the HCTZ group (P<.001). PP and PWV also decreased significantly with HCTZ and SPIRO treatments (ANOVA P<.001).
CONCLUSIONS: Six months of therapy with HCTZ or SPIRO resulted in comparable reductions in 24-hour average and nocturnal SBP and DBP, PP, and PWV in older subjects with hypertension.