Spironolactone trial for high blood pressure after pregnancy in women with overweight
Tests spironolactone against a placebo in women with pregnancy-related high blood pressure after birth.
Plain-language title generated from the registry record
Registry title: Spironolactone to Improve Pregnancy-Associated Hypertension Trajectories
Key facts
- Where
- Boston and Pittsburgh, United StatesSee the 3 sites
- Phase
- Phase 2
Where in United States
- Brigham and Women's HospitalBoston, United StatesTaking people
- Massachusetts General HospitalBoston, United StatesTaking people
- University of Pittsburgh Magee-Womens HospitalPittsburgh, United StatesNot yet recruiting
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Massachusetts General Hospital
- Trial code
- NCT07041281
- Record updated
- 3 April 2026
- Original description
The hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) are associated with increased long-term maternal risk of developing cardiovascular disease. Recent evidence suggests that activation of the mineralocorticoid receptor promotes ongoing susceptibility to hypertension in women following hypertensive disorders of pregnancy. In addition, women with overweight/obesity are at increased risk for progression to chronic hypertension after experiencing hypertensive disorders of pregnancy. Among women with hypertensive disorders of pregnancy and pre-pregnancy overweight/obesity, the investigators will conduct a randomized trial to test the effect of pharmacologically blocking the mineralocorticoid receptor for three months after delivery on blood pressure and cardiac remodeling at nine months postpartum.Read full original descriptionShow less
Spironolactone to Improve Pregnancy-Associated Hypertension Trajectories
The hypertensive disorders of pregnancy (preeclampsia and gestational hypertension) are associated with increased long-term maternal risk of developing cardiovascular disease. Recent evidence suggests that activation of the mineralocorticoid receptor promotes ongoing susceptibility to hypertension in women following hypertensive disorders of pregnancy. In addition, women with overweight/obesity are at increased risk for progression to chronic hypertension after experiencing hypertensive disorders of pregnancy. Among women with hypertensive disorders of pregnancy and pre-pregnancy overweight/obesity, the investigators will conduct a randomized trial to test the effect of pharmacologically blocking the mineralocorticoid receptor for three months after delivery on blood pressure and cardiac remodeling at nine months postpartum.
Inclusion: Females aged ≥18 years; HDP (gestational hypertension or preeclampsia) without pre-pregnancy chronic hypertension; BMI ≥25 kg/m2 prior to pregnancy or in the first trimester; Requirement for antihypertensive medication within one week of delivery; Ability to provide informed consent.
Exclusion: Concomitant use of eplerenone or finerenone; Pre-pregnancy diabetes; Other serious medical illnesses or concerns about protocol adherence/ mortality within 9 months; Hypersensitivity to spironolactone; Addison's disease; LV ejection fraction <50% or history of clinical heart failure with reduced or preserved ejection fraction; Hyperkalemia: potassium >5.3 mEq/L; Estimated glomerular filtration rate (eGFR) <60mL/min/1.73 m2; Hypertrophic or other genetic cardiomyopathy; BMI at screening ≥50 kg/m2; Cirrhosis; Primary aldosteronism; Intention to become pregnant within 9 months; Active substance abuse; Participation in another interventional clinical study.