[PATHWAY-2 Study: spironolactone vs placebo, bisoprolol and doxazosin to determine optimal treatment of resistant hypertension. Spironolactone high effective in lowering blood pressure in drug resistant hypertension].

Abstract

The PATHWAY-2 study, funded by the British Heart Foundation, randomised 335 patients with resistant hypertension (already treated according to guidelines) to sequentially receive 12 weeks of spironolactone (25-50 mg), bisoprolol (5-10 mg), doxazosin (4-8 mg modified release) and placebo. The study design allowed drug comparisons in each patient, with 230 patients completing all cycles. Results showed that spironolactone reduced home systolic BP by 8.70 mm Hg more than placebo (<0.001), 4.26 mmHg more than bisoprolol/doxazosin (<0.001), 4.03 mm Hg more than doxazosin (<0.001), and by 4.48 mm Hg more than bisoprolol. By the end of the trial, there would only be 15 patients considered eligible for renal denervation trials in uncontrolled hypertension. PATHWAY-2 will have significant implications for patient recruitment in to other trials.

• Authors: Jiří Widimský
• Journal: Vnitrni lekarstvi (Vnitr Lek) Vol. 61 Issue 12 Pg. 1067-71 (Dec 2015) ISSN: 0042-773X [Print] Czech Republic
• Vernacular Title: Studie PATHWAY-2: spironolakton vs placebo, bisoprolol a doxazosin ke stanovení optimální léčby hypertenze rezistentní na léky. Vysoká účinnost spironolaktonu ve snížení krevního tlaku u rezistentní hypertenze.
• PMID: 26806502 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Antihypertensive Agents
• Diuretics
• Spironolactone
• Doxazosin
• Bisoprolol

Topics

• Antihypertensive Agents (therapeutic use)
• Bisoprolol (therapeutic use)
• Blood Pressure (drug effects)
• Diuretics (therapeutic use)
• Doxazosin (therapeutic use)
• Drug Therapy, Combination
• Female
• Humans
• Hypertension (drug therapy, physiopathology)
• Male
• Middle Aged
• Spironolactone (therapeutic use)