依普利酮疗效如何呢？

In recent years, more and more evidence has shown that other tissues, especially the heart, brain and blood vessels, can also independently synthesize aldosterone. Not only that, it can also directly affect blood pressure and damage the heart, brain, kidneys and other organs. Overactivation of the renin-angiotensin-aldosterone system (RAAS) is an important factor that aggravates myocardial damage, myocardial remodeling, and promotes the progression of heart failure (heart failure). The degree of activation of this system affects patient prognosis and death. Blocking excessive activation of RAAS is an important measure to improve ventricular remodeling, heart failure prognosis, and reduce heart failure mortality. It is the first selective aldosterone receptor blocker approved for marketing.

The commonly used domestic aldosterone receptor antagonist spironolactone has a significant protective effect on the cardiovascular system, but its sex hormone-related side effects limit its application. Eplerenone, as a new generation of selective aldosterone receptor antagonist, provides a new method for the treatment of cardiovascular diseases.

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, the addition of eplerenone to standard treatment can reduce all-cause death by 15%, primary combined endpoint events (cardiovascular death or hospitalization for cardiovascular events) by 17%, and sudden cardiac death (sudden cardiac death) by 21%. cardiac death, SCD).

The combination of eplerenone and enalapril can significantly reduce left ventricular weight, and the addition of hydrochlorothiazide and amlodipine can further reduce it. Previous studies have confirmed that left ventricular mass index is associated with event-free survival. In studies on patients with diabetes mellitus and proteinuria, both eplerenone and enalapril can reduce systolic blood pressure and diastolic blood pressure, but eplerenone reduces the urinary albumin/inosine ratio UACR more significantly than enalapril.

As the first selective aldosterone receptor antagonist, it has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of hypertension. The "China Hypertension Prevention and Treatment Guidelines 2010" also proposed eplerenone as one of the main antihypertensive drugs.