Aldosterone receptor antagonists: focus on eplerenone.
Despite the development of hypertension treatment guidelines, blood pressure control in the general population remains inadequate, indicating the need for ongoing re-evaluation of treatment strategies to further improve blood pressure control. Hypertension results from alterations in cardiac output and/or peripheral resistance. The renin-angiotensin-aldosterone system may be responsible, at least in part, for these alterations. Despite pharmacologic intervention with angiotensin-converting enzyme inhibitors and angiotensin type-1 receptor antagonists, aldosterone continues to be produced. Therapeutic modalities for treating hypertension directed toward antagonizing aldosterone might more effectively control blood pressure. Eplerenone, a new selective aldosterone receptor antagonist, recently received approval from the US Food and Drug Administration for the treatment of hypertension, either alone or in combination with other antihypertensive agents. The objective of this review is to summarize the renin-angiotensin-aldosterone system, emphasizing the role for aldosterone antagonism in the management of hypertension, with a focus on eplerenone.
Lamb
Robert E
RE
AstraZeneca LP, 725 Chesterbrook Boulevard, Wayne, PA 19087, USA. robert.lamb@astrazeneca.com
Folstad
Jon
J
D000959:Antihypertensive Agents / Q000037:antagonists & inhibitors / Q000592:standards / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D000077545:Eplerenone; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000592:standards / Q000627:therapeutic use; D018161:Receptors, Mineralocorticoid / Q000627:therapeutic use; D012084:Renin-Angiotensin System / Q000187:drug effects; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000037:antagonists & inhibitors / Q000592:standards / Q000627:therapeutic use; D014481:United States; D014655:Vascular Resistance / Q000187:drug effects
D000959:Antihypertensive Agents; D000451:Mineralocorticoid Receptor Antagonists; D018161:Receptors, Mineralocorticoid; D013148:Spironolactone; D000077545:Eplerenone