A clinical trial of a spironolactone/thiazide combination in the treatment of hypertension in Zambian Africans

Summary

A clinical trial was carried out to compare the eflects of placebo and of a spironolactone-althiazide combination in the treatment of 24 Zambian Africans with hypertension. After an initial 2 weeks on placebo, patients received 100 mg spironolactone plus 60 mg althiazide daily for 12 weeks. They were then treated with placebo again for 3 to 5 weeks, followed by a second active treatment period of 6 to 8 weeks in dosages ranging from 50 mg spironolactone plus 30 mg althiazide to 150 mg spironolactone plus 90 mg althiazide according to the previous response. A statistically significant (p <0.001) reduction was noted in both systolic and diastolic blood pressures whilst on active treatment. Mean reductions were 30/16 mmHgfor supine and 35/21 mmHg for standing blood pressures. Treatment with the combination product did not influence serum potassium or creatinine levels. Mean blood urea, however, increased from 23.6 to 35.1 mg/100 ml and the mean serum uric acid from 6.7 to 8.9 mg/100 ml. No serious side-effects were seen.

Key Words::

• Spironolactone
• Diuretic
• thiazide
• drug combinations
• anti-hypertensive agents
• hypertension