PT - JOURNAL ARTICLE AU - J. H. Kreeft AU - P. Larochelle AU - R. I. Ogilvie TI - Comparison of chlorthalidone and spironolactone in low--renin essential hypertension DP - 1983 Jan 01 TA - Canadian Medical Association Journal PG - 31--34 VI - 128 IP - 1 4099 - http://www.cmaj.ca/content/128/1/31.short 4100 - http://www.cmaj.ca/content/128/1/31.full SO - CMAJ1983 Jan 01; 128 AB - Nineteen patients with uncomplicated essential hypertension and low activity of plasma renin in response to a change from recumbency to an upright posture along with furosemide administration were given spironolactone, 400 mg/d, or chlorthalidone, 100mg/d, in a double-blind, random-sequence, crossover trial. The sequence of treatments was placebo for 2 months, one active drug for 2 months, placebo again for 1 month and the other active drug for 2 months. With both active treatments the average systolic, diastolic and mean arterial pressures decreased significantly. The two agents were equally efficacious in lowering the blood pressure regardless of the severity of hypertension during placebo treatment. Body weight, 24--hour urinary excretion of sodium, the plasma renin activity and the plasma aldosterone level at the end of the initial placebo period did not allow us to predict the response to either drug. Both drugs reduced the body weight and increased the stimulated plasma renin level activity. Chlorthalidone significantly increased the serum uric acid level and significantly reduced the serum potassium level. Three patients experienced orthostatic dizziness during spironolactone therapy, but no adverse symptoms were observed with chlorthalidone therapy. Thus, spironolactone is an effective alternative to thiazide-type drugs in patients with low-renin essential hypertension.