Efficacy and tolerability of eplerenone and losartan in hypertensive black and white patients

Abstract

The antihypertensive effect of eplerenone was equal in black and white patients and was superior to losartan in black patients.

Clinical effects of eplerenone, a selective aldosterone blocker, in Japanese patients with essential hypertension

“…Clinical research to date has shown that eplerenone when used alone or with other major antihypertensive drugs achieves excellent antihypertensive effects. [13][14][15][16][17][18][19][20] One of the intriguing properties of eplerenone is that its antihypertensive effect is not compromised in low-renin hypertensive patients, which means that it reduces blood pressure independently of the patient's renin profile. [14][15][16]26 This property makes eplerenone effective for Japanese patients who tend to have high salt intake.…”

“…Eplerenone showed a stable antihypertensive effect regardless of the baseline active renin concentration, whereas the antihypertensive effect of losartan correlated with the active renin concentration. Flack et al 15 further compared the efficacies of eplerenone and losartan in African Americans with typical low-renin hypertension and Caucasians with normal to high-renin hypertension. The two drugs produced similar degrees of blood pressure reduction in Caucasians, although eplerenone exerted a significantly greater degree of blood pressure reduction in African-American hypertensive patients.…”

“…After 12 weeks of treatment, one patient each from the placebo and eplerenone 200 mg groups developed hyperkalemia of X5.5 mEq l À1 , but the authors concluded that the increased dose of eplerenone was not associated with the serum potassium increase. Flack et al 15 compared the antihypertensive effect and safety of eplerenone (starting with 50 mg and allowing increases up to 200 mg) with those of losartan and a placebo in patients with mild-to-moderate essential hypertension. The frequency of hyperkalemia was 0.6% in the placebo group, and 1.1% in the eplerenone group, not a statistically significant difference.…”

“…Currently, eplerenone is indicated for heart failure in 460 countries based on its anticipated beneficial cardiac effect. 7 It has been reported that eplerenone also has a stable antihypertensive effect, [13][14][15][16][17][18][19][20] with a profile slightly different from that of spironolactone, 21 and fewer adverse reactions, suggesting that it may become a first-line treatment for hypertension. However, clinical data on hypertensive patients in Japan are lacking for eplerenone.…”

Effects of eplerenone, a selective mineralocorticoid receptor antagonist, on clinical and experimental salt-sensitive hypertension

“…This subgroup of patients may respond better to eplerenone, which reduces sodium and fluid retention by the kidneys. 27 However, a comparison with thiazide diuretics, which can also be effective in these patients, is currently lacking. There are, however, considerable clinical data that treatment with thiazide diuretics in patients with hypertension induces glucose intolerance or diabetes mellitus concomitantly with hypokalemia.…”