eplerenone治疗高血压的效果怎样？

Approved in the United States in 2002, it has definite efficacy in the treatment of hypertension, heart failure and myocardial infarction, has fewer adverse reactions and is well tolerated. Eplerenone has a protective effect on the liver, heart disease, and kidneys without damaging the organs. eplerenone can promote urination without losing potassium.

So how effective is eplerenone in treating high blood pressure?

In the treatment of heart failure: The EPHESUS trial showed that for patients with left ventricular ejection fraction (LVEF) <40% and heart failure within 3 to 14 days after myocardial infarction, adding eplerenone to standard treatment can reduce all-cause death by 15%, primary combined endpoints (cardiovascular death or hospitalization for cardiovascular events) by 17%, and 21% by 21%. of sudden cardiac death (SCD). For patients with a history of hypertension after acute myocardial infarction, heart failure, and LVEF ≤ 40%, the addition of eplerenone can significantly reduce all-cause mortality, primary combined endpoints, and SCD. For patients without a history of hypertension, although eplerenone can reduce heart failure hospitalizations, it does not reduce mortality and other endpoints. Hospitalization due to hypertension is a risk factor for cardiovascular death, and eplerenone can reduce the risk of hospitalization due to hypertension in people without a history of hypertension. Because eplerenone is used early (3-7 days) after acute myocardial infarction, it can reduce primary combined endpoint events by 24% and SCD by 34%. However, if eplerenone is used for ≥ 7 days, the effect of improving the prognosis is not obvious.

In the treatment of hypertension: eplerenone treats patients with stage 1 and stage 2 hypertension, and its effectiveness and magnitude in reducing systolic and diastolic blood pressure are similar to those of enalapril. Eplerenone also has a good antihypertensive effect in patients with essential hypertension with low renin levels for whom angiotensin-converting enzyme inhibitors and angiotensin II receptor inhibitors are ineffective. It also has a good antihypertensive effect on simple systolic hypertension, and has a good antihypertensive effect on diet-induced obesity-related hypertension. In addition, it can significantly reduce the ultrafiltration effect of glomeruli and reduce albuminuria in patients with hypertension. This renal protective effect is more obvious for patients with hypertension combined with diabetes.