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.

NCT Number	NCT07041281
Lead Sponsor	Massachusetts General Hospital Collaborators: Brigham and Women's Hospital, University of Pittsburgh Medical Center
Conditions	Preeclampsia, Gestational Hypertension
Enrollment	204 participants
Start Date	2025-10-16
Primary Completion	2027-12-02 (estimated)
Study Completion	2029-03-02 (estimated)
Updated on ClinicalTrials.gov	2026-04-03