Determinants of blood pressure reduction by eplerenone in uncontrolled hypertension

Jansen, Pieter; Frenkel, Wijnanda J.; Born, Bert‐Jan H. van den; Bruijne, E.L.E. de; Deinum, Jaap; Kerstens, Michiel N.; Arnoldus, Joyce H. A.; Woittiez, Arend Jan; Wijbenga, J.A.M.; Zietse, Robert; Danser, A.H. Jan; Meiracker, Anton H. van den

doi:10.1097/hjh.0b013e32835b71d6

Cited by 24 publications

(10 citation statements)

References 49 publications

(81 reference statements)

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“…Two studies reported the adverse events associated with spironolactone treatment, which included gynecomastia, breast pain in females and impotence. The early trials of spironolactone demonstrated its efficacy at doses up to over 200 mg, whereas lower doses of spironolactone have recently been used to avoid dose-and time-dependent adverse events while maintaining the drug's antihypertensive effects [22,23]. Our data with lower doses of spironolactone or eplerenone might be more practical.…”

Section: Discussionmentioning

confidence: 73%

Comparison of eplerenone and spironolactone for the treatment of primary aldosteronism

et al. 2015

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Section: Discussionmentioning

confidence: 73%

Comparison of eplerenone and spironolactone for the treatment of primary aldosteronism

et al. 2015

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“…Eplerenone also has a substantial extra blood pressure lowering effect as add-on treatment in difficult to control hypertension (Burgess et al, 2003;Jansen et al, 2013;Krum et al, 2002). This suggests that aldosterone plays a role in difficult to treat hypertension.…”

Section: Accepted Manuscriptmentioning

confidence: 97%

Pharmacological treatment of aldosterone excess

Deinum

Riksen

Lenders

2015

Pharmacology & Therapeutics

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“…[236][237][238][239][240][241][242][243][244][245][246][247] Aldosterone blockade by spironolactone was shown to reduce all-cause mortality in adults with symptomatic HF by 35% when it was added to standard HF therapy in the RALES trial (Randomized Aldactone Evaluation Study). 248 Subsequently, eplerenone was found to provide a similar survival benefit in adults with HF caused by LV dysfunction 249,250 In addition to improving survival and hospitalization rates, canrenone and spironolactone have been associated with reverse remodeling in adults with HF.…”

Section: Mineralocorticoid Antagonistsmentioning

confidence: 99%

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

Feingold¹,

Mahle²,

Auerbach³

et al. 2017

Circulation

205

195

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For many neuromuscular diseases (NMDs), cardiac disease represents a major cause of morbidity and mortality. The management of cardiac disease in NMDs is made challenging by the broad clinical heterogeneity that exists among many NMDs and by limited knowledge about disease-specific cardiovascular pathogenesis and course-modifying interventions. The overlay of compromise in peripheral muscle function and other organ systems, such as the lungs, also makes the simple application of endorsed adult or pediatric heart failure guidelines to the NMD population problematic. In this statement, we provide background on several NMDs in which there is cardiac involvement, highlighting unique features of NMD-associated myocardial disease that require clinicians to tailor their approach to prevention and treatment of heart failure. Undoubtedly, further investigations are required to best inform future guidelines on NMD-specific cardiovascular health risks, treatments, and outcomes. N euromuscular diseases (NMDs) encompass a broad spectrum of diagnoses with overlapping but distinct phenotypes. Common to many NMDs is cardiac involvement. Although the past 3 decades have seen marked advances in our understanding of many NMDs, significant gaps in knowledge remain on how best to approach cardiac care in these patients. For example, survival in Duchenne muscular dystrophy (DMD) has been extended through the use of glucocorticoid use and respiratory support, yet cardiac complications remain a significant cause of morbidity and mortality.1-3 To achieve further gains in care, we will need to improve our understanding of the pathophysiologies driving cardiac involvement in NMDs and advance treatments aimed at preventing the progression of heart failure (HF) and sudden death in NMDs. The recently published findings of an expert working group on cardiac involvement in DMD, which outlined key gaps in knowledge and made specific recommendations aimed at improving diagnosis and management, are a step toward this goal. 4 In this statement, we include a comprehensive overview of the major categories of NMDs with cardiac involvement. For each, a brief background of the gene defect(s), common clinical manifestations (particularly cardiac findings), and current therapies is summarized. Gaps in knowledge are highlighted, and where possible, clinical treatment suggestions are made by the expert writing group appointed by the American Heart Association to review the available literature. Selection of the writing group was performed in accordance with the American Heart Association's conflict-of-interest management policy. Participants volunteered to write sections relevant to their expertise and experience. CLINICAL STATEMENTS AND GUIDELINESconducted a general search of the literature, restricted to human subjects research published between 1980 and 2016. Drafts of each section were written and sent to the chair of the writing group for incorporation into a single document, which was then edited. The edited document was discussed electron...

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Determinants of blood pressure reduction by eplerenone in uncontrolled hypertension

Abstract: Add-on therapy with eplerenone effectively lowers BP in patients with difficult-to-treat primary hypertension. This effect is unrelated to circulating renin-angiotensin-aldosterone system activity and renal mineralocorticoid receptor activity as assessed by the TTKG.

Cited by 24 publications

References 49 publications

Comparison of eplerenone and spironolactone for the treatment of primary aldosteronism

Comparison of eplerenone and spironolactone for the treatment of primary aldosteronism

Pharmacological treatment of aldosterone excess

Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

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