| Can renin status predict the antihypertensive efficacy of eplerenone add-on therapy? | |
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MedLine Citation:
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PMID: 14551174 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Since neither angiotensin-converting enzyme inhibitors (ACE-I) nor angiotensin II receptor blockers (ARB) can completely suppress aldosterone levels, there is a need for alternative/supplementary antihypertensive medications, such as the selective aldosterone blocker eplerenone (Inspra). This multicenter study measured the safety and efficacy of add-on eplerenone therapy to reduce blood pressure not controlled by ACE-I or ARB monotherapy. An ad hoc analysis evaluated whether active plasma renin or serum aldosterone levels could predict blood pressure response to eplerenone therapy. Patients (N = 341) with a diastolic blood pressure > 95 mmHg on a fixed dose of ACE-I or ARB were randomized to 8 weeks of double-blind treatment with eplerenone 50 mg qd or placebo. If blood pressure remained uncontrolled following 2, 4, or 6 weeks of treatment, the eplerenone dose was increased to 100 mg qd. In a combined cohort analysis of these patients, the placebo-adjusted change in systolic and diastolic blood pressure was -5.9/-2.4 mmHg (p< 0.001 and p = 0.006, respectively). While adding eplerenone to an ACE-I or ARB is safe and effective for blood pressure reduction, there was no baseline value or range of values of active plasma renin, serum aldosterone, or their ratio that predicted a favorable response to either of these drug combinations. |
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Authors:
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L Michael Prisant; Henry Krum; Barbara Roniker; Scott L Krause; Kaffa Fakouhi; Weizhong He |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of clinical pharmacology Volume: 43 ISSN: 0091-2700 ISO Abbreviation: J Clin Pharmacol Publication Date: 2003 Nov |
Date Detail:
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Created Date: 2003-10-10 Completed Date: 2004-03-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0366372 Medline TA: J Clin Pharmacol Country: United States |
Other Details:
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Languages: eng Pagination: 1203-10 Citation Subset: IM |
Affiliation:
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Medical College of Georgia, Augusta, GA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Analysis of Variance Antihypertensive Agents / therapeutic use* Double-Blind Method Drug Therapy, Combination Female Humans Hypertension / blood*, drug therapy* Male Middle Aged Predictive Value of Tests Renin / blood* Single-Blind Method Spironolactone / analogs & derivatives*, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/eplerenone; 52-01-7/Spironolactone; EC 3.4.23.15/Renin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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