title: The velocity of home blood pressure reduction in response to low-dose eplerenone combined with other antihypertensive drugs determined by exponential decay function analysis.
abstract: OBJECTIVE
  Eplerenone is a highly selective aldosterone blocker, which has the potential to lower blood pressure (BP) in patients with hypertension. The objective of this study was to assess the hypotensive effects of low-dose eplerenone (25 mg) using home BP measurements. We also assessed the time required to reach 95% of the maximum antihypertensive effect (stabilization time) by analyzing exponential decay functions using home BP measurements.
  
  
  METHODS
  We reviewed the medical records of 83 hypertensive patients who were taking eplerenone 25 mg (age, 68.6±11.8 years; men, 36.1%) in addition to other antihypertensive agents. Home BPs were averaged in each patient for the last 5 days of each observation period. The morning versus evening effect (M/E ratio) and the evening versus morning effect (E/M ratio) were calculated to assess the duration of action of eplerenone.
  
  
  RESULTS
  The mean home systolic/diastolic BPs at baseline were 136.8±8.8/77.2±9.3 mmHg, respectively. After 8 weeks of treatment with eplerenone, home systolic/diastolic BP significantly decreased by -7.1±10.1/-2.6±5.0 mmHg (p<0.0001). The time for stabilization of home systolic and diastolic BPs was 13.7 days (p=0.006) and 16.5 days (p=0.001), respectively. When eplerenone was administered in the morning, the M/E ratio was 1.1±0.3. The corresponding E/M ratio for evening administration was 0.9±0.6. Although no nocturia was observed, there was a slight but significant increase in serum potassium levels (p=0.03).
  
  
  CONCLUSIONS
  Our data suggest that the combination of eplerenone with other antihypertensive drugs may be a promising therapeutic strategy for the treatment of essential hypertension.
authors.affiliation: Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science , Sendai , Japan .
authors.forename: Noha
authors.initials: N
authors.lastname: Elnagar
authors.forename: Michihiro
authors.initials: M
authors.lastname: Satoh
authors.forename: Miki
authors.initials: M
authors.lastname: Hosaka
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Kazuki
authors.initials: K
authors.lastname: Ishikura
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Nariyasu
authors.initials: N
authors.lastname: Mano
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D001795:Blood Pressure Determination / Q000379:methods; D004359:Drug Therapy, Combination / Q000379:methods; D000077545:Eplerenone; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D013148:Spironolactone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D013148:Spironolactone; D000450:Aldosterone; D000077545:Eplerenone