Effect of spironolactone on patients with resistant hypertension and obstructive sleep apnea.

Objective: To examine whether spironolactone could reduce the severity of obstructive sleep apnea (OSA) and lower blood pressure in patients with resistant hypertension.Methods: This was a blank-controlled, single-center study. Patients with resistant hypertension and moderate-to-severe OSA (apnea–hypopnea index >15 events/h) were enrolled and randomly assigned to the therapy or control group. Patients in the therapy group were administered spironolactone 20 mg once daily (up to 40 mg once daily for 4 weeks, if required) in addition to original antihypertensive medication. Follow-up was 12 weeks.Results: Thirty patients were enrolled (n= 15 per group). After 12 weeks of follow-up, apnea–hypopnea index (21.8 ± 15.7 vs. 1.8 ± 12.8,p< 0.05), hypopnea index (9.8 ± 11.1 vs. −2.7 ± 16.8,p< 0.05), oxygen desaturation index (20.8 ± 15.0 vs. 0.3 ± 16.1,p< 0.05), clinical blood pressure, ambulatory blood pressure, and plasma aldosterone level (9.8 ± 6.3 vs. 2.9 ± 6.7,p< 0.05) were reduced significantly in the therapy group compared with the control group. No side effects were reported.Conclusions: Spironolactone reduced the severity of OSA and reduced blood pressure in resistant hypertension patients with moderate-to-severe OSA. These findings may assist in the treatment of OSA in patients with resistant hypertension. [ABSTRACT FROM AUTHOR]