依普利酮治疗高血压疗效怎样？

It can effectively control high blood pressure, reduce damage to target organs such as the heart, brain and kidneys, and improve microalbuminuria in patients with type 2 diabetes. Its side effects are similar to those of placebo and are well tolerated. So, what is the efficacy of eplerenone in treating hypertension?

The therapeutic effect of eplerenone in treating hypertension:

Compare the efficacy and safety of eplerenone 50 mg or 100 mg and irbesartan 150 mg or 300 mg once/d in the treatment of mild to moderate hypertension.

92 cases of mild to moderate hypertension (90 mmHg ≤ diastolic blood pressure < 110 mmHg and systolic blood pressure < 180 mmHg, 1 mmHg = 0.133 kPa) were divided into the eplerenone group (46 cases) and the irbesartan group (46 cases), who were orally administered 50 mg of eplerenone or 150 mg of irbesartan once a day respectively. Follow-up visits are conducted every 2 weeks. If the diastolic blood pressure is ≥90 mmHg after 4 weeks, the patient will be prescribed eplerenone 100 mg or irbesartan 300 mg orally once a day.

Before treatment and after the 12-week treatment period, liver and kidney function, electrolytes, blood sugar, blood lipids, blood routine, urine routine and ambulatory blood pressure were monitored.

Results ① In the eplerenone group, 41 patients with hypertension completed the trial and 5 were lost to follow-up; in the irbesartan group, 44 patients completed the trial and 2 were lost to follow-up;

② Compared with before treatment, the sitting systolic blood pressure, diastolic blood pressure and ambulatory blood pressure parameters of hypertensive patients in the eplerenone group and irbesartan group were significantly reduced;

③At the end of 12 weeks of treatment, the reduction in seated systolic blood pressure and diastolic blood pressure in the eplerenone group was similar to that in the irbesartan group (18.32±8.57mmHg VS 21.37±9.38 mmHg, 13.97±5.31mmHg VS 15.08±6.63mmHg, all P>0.05);

④ Compared with the irbesartan group, there was no significant difference in the 24-hour average systolic blood pressure and average diastolic blood pressure, daytime average systolic blood pressure and average diastolic blood pressure, and nighttime average systolic blood pressure and average diastolic blood pressure in the eplerenone group;

⑤The total incidence of adverse events between the two groups of eplerenone and irbesartan was similar, 15.0% (6/40) vs. 17.9% (7/39), P>0.05).

Conclusion: Oral administration of 50 mg or 100 mg once/d is safe and effective in the treatment of mild to moderate hypertension, and its antihypertensive efficacy is similar to that of irbesartan.