title: Efficacy and safety of the selective aldosterone blocker eplerenone in Japanese patients with hypertension: a randomized, double-blind, placebo-controlled, dose-ranging study.
abstract: Approximately 40% of Japanese patients with essential hypertension, including low-renin hypertension, are inadequately managed. Low-renin hypertension generally responds poorly to angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, but may respond more optimally to diuretics, calcium channel blockers, and aldosterone blockers. This multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-ranging study evaluated the efficacy and safety of the selective aldosterone blocker eplerenone in 193 Japanese patients with essential hypertension. Although not a study inclusion criterion, baseline active plasma renin levels were consistently low (5.7-10.1 mU/L); most patients met the criteria for low-renin hypertension (< or =42.5 mU/L; normal range, 7-76 mU/L). Patients received placebo or eplerenone 50, 100, or 200 mg once daily for 8 weeks. Systolic blood pressure decreased significantly (-6.8 to -10.6 mm Hg vs. -2.1 mm Hg; p< or =0.0022 vs. placebo). Eplerenone offers significant blood pressure reduction with good tolerability in Japanese patients with hypertension, including those with low-renin hypertension.
authors.affiliation: Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. saruta@sc.itc.keio.ac.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Saruta
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kageyama
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogihara
authors.forename: Kunio
authors.initials: K
authors.lastname: Hiwada
authors.forename: Masayo
authors.initials: M
authors.lastname: Ogawa
authors.forename: Kazuji
authors.initials: K
authors.lastname: Tawara
authors.forename: Marjorie
authors.initials: M
authors.lastname: Gatlin
authors.forename: Susan
authors.initials: S
authors.lastname: Garthwaite
authors.forename: Richard
authors.initials: R
authors.lastname: Bittman
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Patrick
mesh_terms: D000328:Adult; D000368:Aged; D004232:Diuretics / Q000009:adverse effects / Q000627:therapeutic use*; D000077545:Eplerenone; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007564:Japan; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D010919:Placebos; D012449:Safety; D013148:Spironolactone / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D010919:Placebos; D013148:Spironolactone; D000077545:Eplerenone