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Abstract
Introduction Hypertension combined with diabetes and hypokalemia is more likely to develop hyperaldosteronism and is at higher risk of cardiovascular events. There is evidence that activation of aldosterone and mineralocorticoid receptors may play a significant role in the occurrence of cardiovascular events in patients with hypertension and diabetes. Clinical studies have demonstrated that spironolactone can reduce the incidence of cardiovascular events in patients with chronic kidney diseases or severe heart failure. However, the effect of spironolactone on cardiovascular risk in patients with hypertension and glucose metabolism disorders (GMD) and low potassium has been scarcely studied. Therefore, this study aims to evaluate whether add-on spironolactone (conventional antihypertensive drugs alone vs conventional antihypertensive drugs+spironolactone) can reduce the morbidity and mortality of cardiovascular events in this population.
Methods and analysis In this multicentre, randomised, parallel-controlled study, a total of 7140 hypertensive patients aged 45–75 years with GMD and low potassium will be randomised in a 1:1 manner to the control or the spironolactone group (20 mg/day or with a maximum dose of 40 mg). The primary objective is to estimate the difference in the HR of composite cardiovascular events between the two groups. We will also assess the effects of spironolactone on individual cardiovascular events and the progression of diabetes and renal dysfunction.
Ethics and dissemination This protocol was approved by the Independent Ethics Committee of People’s Hospital of Xinjiang Uygur Autonomous Region (no. 2020020618). The results will be disseminated in peer-reviewed journals and at scientific conferences.
Trial registration number ChiCTR2000028909.
- hypertension
- diabetes & endocrinology
- cardiology
- clinical trials
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Footnotes
NL and ML contributed equally.
Contributors NL conceived and designed the study, and led the proposal and protocol development. ML, QL, MH, LW, XY, JH and QZ participated in study design and planned the analyses. ML drafted the initial manuscript, and MH, YL and JY revised it carefully. All authors read and approved the final manuscript.
Funding This work is funded by the NHC Key Laboratory of Hypertension Clinical Research (grant number: 2019[155]) and the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (grant number: 2019PT330003). The funding body will not intervene in the design of the study, analysis of data or writing of the manuscript.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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