Add-On Use of Eplerenone Is Effective for Lowering Home and Ambulatory Blood Pressure in Drug-Resistant Hypertension.
The authors aimed to investigate the blood pressure (BP)-lowering ability of eplerenone in drug-resistant hypertensive patients. A total of 57 drug-resistant hypertensive patients whose home BP was ≥135/85 mm Hg were investigated. The patients were randomized to either an eplerenone group or a control group and followed for 12 weeks. The efficacy was evaluated by clinic, home, and ambulatory BP monitoring. Urinary albumin, pulse wave velocity, and flow-mediated vasodilation (FMD) were also evaluated. Home morning systolic BP (148±15 vs 140±15 mm Hg) and evening systolic BP (137±16 vs 130±16 mm Hg) were significantly lowered in the eplerenone group (n=35) compared with baseline (both P<.05), while unchanged in the control group (n=22). BP reductions in the eplerenone group were most pronounced for ambulatory awake systolic BP (P=.04), awake diastolic BP (P=.004), and 24-hour diastolic BP (P=.02). FMD was significantly improved in the eplerenone group. In patients with drug-resistant hypertension, add-on use of eplerenone was effective in lowering BP, especially home and ambulatory awake BP.
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Kazuo
K
Eguchi
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Tomoyuki
T
Kabutoya
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Satoshi
S
Hoshide
Division of Community and Family Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Shizukiyo
S
Ishikawa
Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Kazuomi
K
Kario
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D018660:Blood Pressure Monitoring, Ambulatory; D004351:Drug Resistance / Q000187:drug effects*; D004359:Drug Therapy, Combination; D000077545:Eplerenone; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D013148:Spironolactone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology
D000959:Antihypertensive Agents; D013148:Spironolactone; D000077545:Eplerenone