Combination of low dose spironolactone with amlodipine on insulin resistance in obesity-associated hypertensive patients

Objective To observe the effects of combination of low dose spironolactone with amlodipine on blood pressure and insulin resistance in obesity-associated hypertensive patients.Methods Ninety-eight obesity-associated hypertensive patients,among which 50 patients were treated with low dose spironolactone 20 mg/d combined amlodipine 5 mg/d(combined group),and other 48 patients treated with amlodipine 5 mg/d(control group) for 24 weeks.BMI,WHR,blood pressure,fasting blood glucose,fasting insulin level and HOMA-IR were assayed during the tests.Results Compared with pre-treatment,systolic blood pressure(SBP) (135.8±9.7) mmHg vs(146.4±9.4) mmHg in control group;(129.2±7.9) mmHg vs(148.2±10.3) mmHg in combined group;and diastolic blood pressure(DBP)(86.1±4.9) mmHg vs(98.4±10.4) mmHg in control group;(80.3±5.6) mmHg vs(99.8±10.7) mmHg in combined group,decreased significantly after 24 weeks' treatment(P0.05).SBP and DBP in combined group were decreased significantly than those in control group(P0.05).After treatment,the level of plasma aldosterone(122.4±19.7) ng/L vs(162.7±22.5) ng/L and HOMAIR(5.8±2.0) vs(8.9±2.7) in combined group were different significantly compared with those treatment before(P0.05).SBP,DBP,plasma aldosterone and HOMA-IR after treatment in combined group were all significantly lower than those in control group(P0.05),while those indexes showed no signicant difference between pre-and post-treatment(P0.05).Conclusion The combination of low dose spironolactone and amlodipine is more effective than amlodipine on blood pressure control and can improve obesity-related insulin resistance in obesity-associated hypertensive patients.