| Objective To investigate the clinical efficacy of spironolactone in the treatment of refractory hypertension with adrenal hyperplasia. Methods The patients with adrenal hyperplasia and refractory hypertension were randomly divided into 2 groups: control group (Nifedipine Controlled Release Tablets 30 mg+Candesartan Cilexetil Tablets 8 mg+ Hydrochlorothiazide Tablets 25 mg, n=54) and the observation group (Nifedipine Controlled Release Tablets 30 mg+Candesartan Cilexetil Tablets 8 mg+Hydrochlorothiazide Tablets 25 mg+ spironolactone 40 mg, n=54). The blood pressure, serum potassium, serum creatinine, serum uric acid and blood glucose levels were evaluated before and after treatment in two groups. Results Treatment were effective in both groups. Compared with the control group, blood pressure decreased more significantly in the observation group（P<0.05）. The remarkable efficiency, efficiency and inefficiency of the observation group were 66.7%, 25.9% and 7.4% respectively, while those in the control group were 48.1%, 33.3% and 18.5% respectively. The total effective rate in the observation group (92.6%) was significantly higher than that in the control group (63%) (P<0.05).There was no significant difference in serum potassium, serum creatinine,serum uric acid and blood glucose levels before and after treatment in two groups. Conclusion On the basis of the conventional antihypertensive treatment combined with spironolactone increases the effect of reducing blood pressure, which may be used in refractory hypertension patients with adrenal hyperplasia.