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Low-dose spironolactone reduces plasma fibulin-1 levels in patients with type 2 diabetes and resistant hypertension

Journal of Human Hypertension volume 29, pages 28–32 (2015)Cite this article

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Abstract

Diabetic patients with hypertension are at particularly high risk of vascular damage and consequently cardiovascular and renal disease. Fibulin-1, an extracellular matrix glycoprotein, is increased in arterial tissue and plasma from individuals with type 2 diabetes. This study aimed to evaluate whether antihypertensive treatment with spironolactone changes plasma fibulin-1 levels. In a multicenter, double-blind, randomized, placebo-controlled study, 119 patients with type 2 diabetes and resistant hypertension were included. A dose of spironolactone 25 mg or matching placebo was added to previous treatment at randomization. Blood pressure (BP) and plasma fibulin-1 were measured at baseline and at 16 weeks follow-up. Overall, 112 patients completed the study. All measures of BP were reduced in the spironolactone group at follow-up. Plasma fibulin-1 was significantly reduced after spironolactone treatment (P=0.009), but increased after placebo (P=0.017). Baseline plasma fibulin-1 correlated with BP and estimated glomerular filtration rate. Increased levels of plasma fibulin-1 (P=0.004) were observed in diabetic participants reporting erectile dysfunction as compared with participants who did not. Treatment with low-dose spironolactone reduced plasma fibulin-1 levels in patients with type 2 diabetes and resistant hypertension. This supports the hypothesis that the antihypertensive effect of the mineralocorticoid receptor blocker in part may be due to regression of vascular remodeling.

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Acknowledgements

The region of Southern Denmark provided financial support for this study. Study medication was donated by Nycomed, Denmark.

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Authors and Affiliations

  1. Department of Endocrinology, Research Unit for Cardiovascular and Metabolic Prevention, Odense University Hospital, Odense C, Denmark

    C S Oxlund, J E Henriksen & I A Jacobsen

  2. Centre for individualized Medicine in Arterial Diseases, Odense University Hospital, Odense C, Denmark

    C S Oxlund & C Cangemi

  3. Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense C, Denmark

    C Cangemi & L M Rasmussen

  4. Department of Endocrinology, Esbjerg, Denmark

    J Gram & L M Rasmussen

  5. Department of Medicine, Fredericia, Denmark

    K Schousboe

  6. Steno Diabetes Centre, Gentofte, Denmark

    L Tarnow

  7. Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina, Charleston, SC, USA

    W S Argraves

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  1. C S Oxlund
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  2. C Cangemi
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  3. J E Henriksen
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  4. I A Jacobsen
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  7. L Tarnow
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  8. W S Argraves
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  9. L M Rasmussen
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Correspondence to C S Oxlund.

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Oxlund, C., Cangemi, C., Henriksen, J. et al. Low-dose spironolactone reduces plasma fibulin-1 levels in patients with type 2 diabetes and resistant hypertension. J Hum Hypertens 29, 28–32 (2015). https://doi.org/10.1038/jhh.2014.27

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  • DOI: https://doi.org/10.1038/jhh.2014.27

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