依普利酮对高血压有多大疗效？

(Eplerenone) is a new type of selective aldosterone receptor blocker that can effectively control hypertension, reduce damage to target organs such as the heart, brain and kidneys, and improve microalbuminuria in patients with type 2 diabetes. It was approved for clinical use by the U.S. Food and Drug Administration in 2002. The pure product is white or off-white crystals. It has stronger aldosterone antagonism than spironolactone, and has extremely low affinity for androgen and progesterone receptors. It has few adverse reactions. It has definite efficacy in the treatment of hypertension, heart failure and myocardial infarction. It has fewer adverse reactions and good tolerance. It is a good alternative drug to spironolactone.

The clinical trial uses losartan as a reference to evaluate the clinical efficacy and safety of eplerenone tablets in the treatment of mild to moderate essential hypertension. Methods: 72 patients with mild to moderate hypertension were randomly divided into: ambulatory blood pressure group, losartan group, and eplerenone group, with 24 cases in each group. The losartan group and the eplerenone group adopted a double-simulation and positive drug parallel control method and received losartan and eplerenone treatment respectively. After 4 weeks of treatment, if the blood pressure did not reach the target, the drug dose was doubled and the treatment continued for 4 weeks; if the blood pressure reached the target, the original dose was maintained and the treatment continued for 4 weeks. The ambulatory blood pressure group took eplerenone 25 mg once a day.

The results showed that after 8 weeks of treatment, compared with before treatment, the average sitting diastolic blood pressure of the group decreased by (13.32±4.57) mmHg, and that of the losartan group decreased by (10.90±5.64) mmHg. There was no statistically significant difference between the two groups. After 8 weeks of treatment, compared with before treatment, the average sitting systolic blood pressure of the eplerenone group decreased by (23.56±9.39) mmHg, and that of the losartan group decreased by (18.67±7.00) mmHg. There was no statistically significant difference between the two groups; the average sitting systolic blood pressure of the eplerenone group and the losartan group reached the standard. The antihypertensive effective rates were 83.33% and 91.30% respectively, with no statistically significant difference between the two groups; the antihypertensive effective rates were 75.0% and 60.9%, respectively, and the total antihypertensive effective rates were 91.7% and 91.3%, respectively. There was no statistically significant difference between the two groups in the antihypertensive effective rate and total antihypertensive effective rate.