Document Detail


Efficacy of eplerenone added to renin-angiotensin blockade in elderly hypertensive patients: the Jichi-Eplerenone Treatment (JET) study.
MedLine Citation:
PMID:  21393354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: We assessed the additional effects of eplerenone to angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on 24-h blood pressure (BP) level, fibrinolytic activity, and cardiovascular protection in elderly (>60 years) hypertensive patients.
MATERIALS AND METHODS: In total, 20 patients (mean age 74 years, 25% men), whose BP was uncontrolled despite the use of anti-hypertensive drugs including ACEIs or ARBs (average 2.4 drugs), received eplerenone once daily (mean 37.5 mg) for 24 weeks.
RESULTS: Eplerenone treatment significantly reduced mean 24-h systolic/diastolic BP levels (143/80 mmHg to 132/74 mmHg, both p < 0.002). The reduction of 24-h systolic BP levels, especially night-time BP, was significantly associated with the reduction of atrial natriuretic peptide and brain natriuretic peptide levels (all p < 0.05). Furthermore, after eplerenone treatment, the mean plasminogen activator inhibitor-1 antigen level was significantly reduced (35 ng/ml to 25 ng/ml, p < 0.05), and the median level of plasma procollagen type III aminoterminal peptide and the urinary albumin excretion rate were also significantly reduced (0.8 U/ml to 0.6 U/ml, p < 0.003 and 53 mg/g·Cr to 23 mg/g·Cr, p < 0.05, respectively). During the intervention, eplerenone treatment was well tolerated with no reports of hyperkalaemia or hypotension.
CONCLUSIONS: Addition of eplerenone to ACEIs or ARBs in elderly hypertensive patients offers significant benefits in terms of 24-h BP levels, fibrinolysis, and cardiovascular protection.
Authors:
Yuichiro Yano; Satoshi Hoshide; Noboru Tamaki; Masahiko Nagata; Kouji Sasaki; Yoshimasa Kanemaru; Kazuyuki Shimada; Kazuomi Kario
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Publication Detail:
Type:  Journal Article     Date:  2011-03-10
Journal Detail:
Title:  Journal of the renin-angiotensin-aldosterone system : JRAAS     Volume:  12     ISSN:  1752-8976     ISO Abbreviation:  J Renin Angiotensin Aldosterone Syst     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-09-01     Completed Date:  2011-12-27     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  100971636     Medline TA:  J Renin Angiotensin Aldosterone Syst     Country:  England    
Other Details:
Languages:  eng     Pagination:  340-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / pharmacology*,  therapeutic use*
Blood Pressure / drug effects*
Female
Hemostasis / drug effects
Humans
Hypertension / blood,  drug therapy*,  physiopathology
Japan
Male
Peptide Fragments / blood
Procollagen / blood
Renin
Renin-Angiotensin System / drug effects*
Spironolactone / analogs & derivatives*,  pharmacology,  therapeutic use
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Peptide Fragments; 0/Procollagen; 0/procollagen Type III-N-terminal peptide; 27O7W4T232/Spironolactone; 6995V82D0B/eplerenone; EC 3.4.23.15/Renin

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


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