| Clinical implications of aldosterone blockade. | |
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MedLine Citation:
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PMID: 12422136 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Michael A Weber |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: American heart journal Volume: 144 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2002 Nov |
Date Detail:
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Created Date: 2002-11-07 Completed Date: 2002-11-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: S12-8 Citation Subset: AIM; IM |
Affiliation:
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SUNY Health Science Center at Brooklyn, Brooklyn, NY 11203, USA. michaelwebermd@cs.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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