Document Detail


Clinical implications of aldosterone blockade.
MedLine Citation:
PMID:  12422136     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aldosterone contributes to hypertension, cardiac and vascular remodeling, and heart failure. The significant risk reduction provided by the addition of spironolactone to standard therapy in patients with severe heart failure has renewed interest in aldosterone blockade. METHODS: This review describes recent clinical studies of eplerenone, a selective aldosterone blocker, in patients with hypertension. RESULTS: In a 16-week study, eplerenone was more effective than placebo or losartan in lowering systolic blood pressure (BP) and diastolic BP in black patients with mild to moderate hypertension. The BP-lowering efficacy of eplerenone was similar in blacks and whites. In a separate study in patients whose BP was controlled inadequately by angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, addition of eplerenone significantly reduced systolic BP, and to a lesser extent, diastolic BP. There were no significant changes in potassium levels in this study. Eplerenone increased active renin and aldosterone levels, indicating that it blocks the renin-angiotensin-aldosterone system. Gynecomastia, or breast tenderness, was uncommon and occurred at a rate comparable to placebo. CONCLUSIONS: Eplerenone is a selective aldosterone blocker that effectively lowers BP in both white and black patients with hypertension and provides meaningful further antihypertensive efficacy when added to patients whose hypertension is inadequately controlled by angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers.
Authors:
Michael A Weber
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American heart journal     Volume:  144     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-07     Completed Date:  2002-11-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S12-8     Citation Subset:  AIM; IM    
Affiliation:
SUNY Health Science Center at Brooklyn, Brooklyn, NY 11203, USA. michaelwebermd@cs.com
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group
Aldosterone / physiology*
Aldosterone Antagonists / therapeutic use*
Antihypertensive Agents / therapeutic use
Blood Pressure / drug effects
Cardiovascular Diseases / etiology,  mortality,  prevention & control
Clinical Trials as Topic
Humans
Hypertension / blood,  complications,  drug therapy*,  epidemiology
Kidney Diseases / etiology,  prevention & control
Losartan / therapeutic use
Potassium / blood
Renin-Angiotensin System / drug effects
Spironolactone / analogs & derivatives*,  therapeutic use*
Chemical
Reg. No./Substance:
0/Aldosterone Antagonists; 0/Antihypertensive Agents; 0/eplerenone; 114798-26-4/Losartan; 52-01-7/Spironolactone; 52-39-1/Aldosterone; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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