Subjects will take spironolactone 20~40mg once daily on top of amlodipine 5~10mg once daily.

Subjects will take indapamide 1.5~3.0mg once daily on top of amlodipine 5~10mg once daily.

Hypertension

After a 2-week run-in period on amlodipine, patients who still have SBP ≥ 140mmHg will take spironolactone 20mg once daily on top of amlodipine for 12 months. During the first two months after randomization, spironolactone can be titrated to 40mg if office SBP remains ≥ 140mmHg.

Spironolactone

After a 2-week run-in period on amlodipine, patients who still have SBP ≥ 140mmHg will take extended-release indapamide 1.5mg once daily on top of amlodipine for 12 months. During the first two months after randomization, indapamide can be titrated to 3mg if office SBP remains ≥ 140mmHg.

Indapamide

After a 2-week run-in period on amlodipine 5mg once daily, patients who still have SBP ≥ 140mmHg will be randomized to add spironolactone 20mg once daily or extended-release indapamide 1.5mg once daily to amlodipine for 12 months. During the first two months after randomization, amlodipine can be titrated to 10mg if office SBP remains ≥ 140mmHg.

Amlodipine

Peking University Third Hospital

Spironolactone Versus Indapamide in Obese and Hypertensive Patients

Evaluation of spironolactoNe Versus Indapamide on Target Organ Damage in Patients With Obesity and hYpertension(ENVOY)

change in left atrial volume index (LAVI) from baseline to the end of study period of 12 months

change in carotid-femoral pulse wave velocity (PWV) from baseline to the end of study period of 12 months

University of Michigan

Peking University

K-supplement- Klor-Con® M10 is an immediately dispersing extended-release oral dosage form of potassium chloride containing 750 mg of microencapsulated potassium chloride, United States Pharmacopeia (USP) equivalent to 10 milliequivalent (mEq) of potassium in a tablet. Participants will be instructed to take two 10 mEq tablets twice daily in a blinded encapsulated form, for 3 months

Placebo - An inert powdered placebo will be identically encapsulated as the Klor-Con intervention tablets to maintain blinding. Participants will be instructed to take two tablets twice daily in a blinded encapsulated form, for 3 months
Subjects will be instructed to take the pills

K-supplement- Klor-Con® M10 is an immediately dispersing extended-release oral dosage form of potassium chloride containing 750 mg of microencapsulated potassium chloride, USP equivalent to 10 mEq of potassium in a tablet. Participants will be instructed to take two 10 mEq tablets twice daily in a blinded encapsulated form, for 3 months
K+ supplement

K+ Supplementation

Placebo - An inert powdered placebo will be identically encapsulated as the Klor-Con intervention tablets to maintain blinding. Participants will be instructed to take two tablets twice daily in a blinded encapsulated form, for 3 months
Subjects will be instructed to take the pills
Placebo

Placebo

Total

Sex: Female, Male

Race (NIH/OMB)

Region of Enrollment

Change in glucose tolerance, as measured by change in glucose area-under-the-curve (Area Under the Curve (AUC) - measured via the trapezoidal method) of 2 hours from the 3-hour Oral Glucose Tolerance Test (OGTT).

Change in Glucose Tolerance as Measured by Area-under-the-curve

Changes in fasting, 1-hour, and 2-hour post-challenge glucose levels in mg/dL

Changes in Fasting, 1-hour, and 2-hour Post-challenge Glucose Levels in mg/dL

Changes in Insulin Secretion as measured by 2-hour insulin area-under-the-curve (AUC - measured via the trapezoidal method) of 2 hours from the 3-hour OGTT.

Changes in Insulin Secretion as Measured by 2-hour Insulin Area-under-the-curve (AUC)

Matsuda Insulin Sensitivity Index was calculated as: 10,000 / square root of [fasting glucose x fasting insulin x mean glucose x mean insulin during Oral Glucose Tolerance Test]).

Changes in Insulin Sensitivity

Overall Study

Ranee Chatterjee Montgomery, M.D.

Borderline Hypokalemia

K+ supplement

Duke University Medical Center

The Effects of Potassium on Glucose Metabolism in African Americans

Duke University

Metabolic Syndrome

Growth hormone stimulation testing, oral glucose tolerance test, hyperinsulinemic euglycemic clamp

hypokalemia/obésité

Spironolactone Versus Indapamide in Obese and Hypertensive Patients

The Effects of Potassium on Glucose Metabolism in African Americans

Metabolic Syndrome in Bone Marrow Transplant Survivors

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