Page 16 - GALENIKA MEDICAL JOURNAL

Zahvalnice
Autori se zahvaljuju podistraživačima TRYCORT studije (azbučnim redom po prezimenima): Antonijević Nebojša,
Ančić Mojsije, Brkanić Belma, Vraneš Danijela, Delalić Čaušević Amela, Đorđević Dikić Ana, Ivanović Branislava, Janković
Nataša, Janjanin Dijana, Kaluđerović Ivan, Kastel Biljana, Klašnja Slobodan, Lasica Ratko, Petrović Dajana, Radovanović
Gorica, Radojković Vesna, Suljendić Elma, Čanković Miroslav.

Finansiranje
Studiju je finansirala Galenika ad Beograd, kao sponzor.

Izjava o pristupu podataka
Originalni podaci ove studije se mogu dobiti od korespondirajućeg autora na razuman zahtev.

Zaključak

Spironolakton se pokazao kao najefikasnija i najbezbednija dodatna terapija rezistentne hipertenzije,
ali mu je potrebno nekoliko meseci redovnog unosa da bi se postigao pun efekat i poboljšao kvalitet

života.

Abstract

Introduction: Treatment-resistant hypertension (TRH) is a frequent phenomenon, for which no complete solution has yet
been found. More than 5% of patients treated for hypertension do not achieve blood pressure control with three first-
generation antihypertensive drugs.

Objective: This new cohort investigation, an extension of the TRYCORT study, aims to re-examine the efficacy and safety of
additional antihypertensive therapy in adult patients with TRH.

Methods: The study was designed as a multi-national, multi-center, prospective cohort study that compared the
effectiveness and safety of add-on treatments for resistant hypertension. The patients were followed up for 6 months, and
the primary outcome was treatment response.

Results: In total 139 patients completed the study (66 women and 73 men), with an average age of 63.6 years. Initial add-
on therapy was changed at study visits if the response to treatment was inadequate. The blood pressure below 140/90
mmHg was achieved in 75% of patients with add-on spironolactone, while effectively all patients achieved a drop in systolic
blood pressure ≥ 10 mmHg, and a drop in diastolic blood pressure ≥ 5 mmHg. Only one treatment-related adverse effect
was observed (pretibial edema in patients taking amlodipine), while serum levels of potassium remained within the
reference limits. Quality of life increased and paralleled the treatment response.

Conclusion: In conclusion, spironolactone proved to be the most effective and safe add-on therapy for resistant
hypertension, but it needs several months of regular intake to achieve full effect and improve quality of life.

Keywords: treatment-resistant hypertension, add-on therapy, treatment response, quality of life

14 DOI: 10.5937/Galmed2412006J