Siddikatou D, Deffo Gv, Ndom Ms, Ndobo V, Mouliom S, Kamdem F, Dzudie A

Background: Hypertension is the leading contributor to the global burden of disease and mortality. Achieving BP control remains a global challenge since some patients often have refractory uncontrolled BP to triple therapy, thus, the necessity for a quadruple therapy.

Objectives: This work aimed at evaluating and comparing the effect of spironolactone versus beta blocker as the fourth drug of the quadruple combination regimen used in the management of resistant hypertension. (RH)

Methods: A hospital-based retrospective cohort study was conducted. Data were collected from November 2019 to November 2022. Patients with RH were enrolled. Sociodemographic and clinical data were collected. Data were analyzed using SPSS version 25

Results: A total of 52 files were identified with RH of which 22 had been placed on spironolactone and 30 on beta-blocker (BB). 67.3% of participants achieved BP control at 16 weeks following initiation of the add-on drug. There was a significant difference in the BP lowering effect of Spironolactone vs BB, 86.4% vs 53.3% (p=0.01), respectively after 16 weeks. There was no significant difference in the tolerance of spironolactone compared to BB. Both drugs were well tolerated.

Conclusion: The overall proportion of BP control achievement was high with a significantly higher effect of Spironolactone compared to beta-blockers in lowering BP. There was no significant difference in the tolerance of both drugs.

Keywords: quadruple therapy, resistant hypertension, spironolactone, beta blocker.