Yang Lirui, Zhang Huimin, Cai Menggengtuya, Zou Yubao, Jiang Xiongjing, Song Lei, Liang Erpeng, Bian Jin, Wu Haiying, Hui Rutai
a Hypertension Division , State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing , China.
b Chronic Disease Department , Centers for Disease Control , Hebukesaier County , Xinjiang Uygur Autonomous Region , China.
Clin Exp Hypertens. 2016;38(5):464-8. doi: 10.3109/10641963.2015.1131290. Epub 2016 Jul 1.
To examine whether spironolactone could reduce the severity of obstructive sleep apnea (OSA) and lower blood pressure in patients with resistant hypertension.
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.
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.
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.
探讨螺内酯是否能减轻难治性高血压患者阻塞性睡眠呼吸暂停（OSA）的严重程度并降低血压。
这是一项空白对照的单中心研究。纳入难治性高血压合并中重度OSA（呼吸暂停低通气指数>15次/小时）的患者，并随机分为治疗组或对照组。治疗组患者在原降压药物基础上，每日服用一次20mg螺内酯（必要时4周内每日一次增至40mg）。随访12周。
共纳入30例患者（每组15例）。随访12周后，与对照组相比，治疗组的呼吸暂停低通气指数（21.8±15.7对1.8±12.8，p<0.05）、低通气指数（9.8±11.1对-2.7±16.8，p<0.05）、氧饱和度下降指数（20.8±15.0对0.3±16.1，p<0.05）、临床血压、动态血压及血浆醛固酮水平（9.8±6.3对2.9±6.7，p<0.05）均显著降低。未报告不良反应。
螺内酯可减轻中重度OSA难治性高血压患者的OSA严重程度并降低血压。这些发现可能有助于难治性高血压患者OSA的治疗。
