依普利酮降血压效果

It is a new generation of selective aldosterone antagonist, used for the treatment of hypertension, heart failure and myocardial infarction. So what is the blood pressure lowering effect of eplerenone?

To evaluate the clinical efficacy and safety of eplerenone tablets in the treatment of mild and moderate essential hypertension.

This study is a randomized, double-blind, parallel-controlled multi-center phase II clinical trial. 235 patients with mild to moderate hypertension were randomly divided into two groups: (1) losartan group (n=118), (2) eplerenone group (n=117).

Patients were treated with losartan and eplerenone respectively. After 4 weeks of treatment, if the blood pressure did not reach the target, the drug dose was doubled and the treatment was continued for 4 weeks; if the blood pressure reached the target, the original dose was maintained and the treatment was continued for 4 weeks. The efficacy and adverse reactions of the two groups were observed.

Results: After 8 weeks of treatment:

①The average sitting diastolic blood pressure in the eplerenone group decreased by (14.09±7.84) mmHg, and the systolic blood pressure decreased by (19.77±10.89) mmHg. In the losartan group, the average sitting diastolic blood pressure decreased by (12.87±8.04) mmHg, and (18.63±9.66) mmHg respectively. The difference between the two groups The differences were not statistically significant (both P>0.05); the average sitting blood pressure compliance rates in the eplerenone group and losartan group were 77.6% and 73.50% respectively, the apparent blood pressure lowering efficiencies were 65.5% and 56.6% respectively, and the total effective rates were 87.9% and 82.3% respectively. There was no statistical significance between the two groups ( P>0.05).

②There was no significant difference in the incidence of adverse events and adverse reactions between the two groups ( P >0.05).

Conclusion: Eplerenone can effectively lower blood pressure and has good safety profile.

The outstanding advantage is that for severe hypertension that cannot be controlled by a combination of multiple antihypertensive drugs, the addition of eplerenone can significantly reduce blood pressure, especially the decrease in systolic blood pressure is more significant. For patients with severe heart failure and myocardial infarction, eplerenone combined with angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers can improve quality of life and reduce mortality.

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