Efficacy of eplerenone versus enalapril as monotherapy in systemic hypertension

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.…”

“…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.…”

A Comparison of the Aldosterone‐blocking Agents Eplerenone and Spironolactone

“…25 -27 For studies that used a serum potassium threshold 6.0 mEq/L, the incidence of hyperkalemia ranged from 0% to 11% at eplerenone doses of 50-200 mg/day. 27,28 Figure 1 displays the mean change from baseline in serum potassium associated with spironolactone and eplerenone from the previously described trial evaluating spironolactone 100 mg/day and eplerenone 50-400 mg/day. The change in potassium with eplerenone 100 mg/day was significantly less than that of spironolactone 50 mg twice daily, although none of the patients experienced clinical symptoms related to hyperkalemia.…”

Aldosterone Stimulates Collagen Gene Expression and Synthesis Via Activation of ERK1/2 in Rat Renal Fibroblasts

“…In addition, both eplerenone and PD98059 prevented the aldosterone-induced increases in types I, III, and IV collagen mRNA and [ Key Words: aldosterone Ⅲ collagen Ⅲ fibroblasts Ⅲ mineralocorticoids R ecent studies have indicated the usefulness of mineralocorticoid receptor (MR) antagonists in ameliorating renal injury. [1][2][3][4][5][6][7][8][9][10][11][12][13] In stroke-prone spontaneously hypertensive rats 4 and rats treated with angiotensin II and a nitric oxide synthase inhibitor, 5 cyclosporine A, 6 or radiation, 7 MR antagonists had no effect on systemic blood pressure but markedly ameliorated glomerular and tubulointerstitial fibrosis. In clinical studies, the addition of a nonselective MR antagonist, spironolactone, to angiotensin-converting enzyme inhibitors had no hemodynamic effects but markedly reduced proteinuria in patients with chronic renal failure 8 and early diabetic nephropathy.…”

“…In clinical studies, the addition of a nonselective MR antagonist, spironolactone, to angiotensin-converting enzyme inhibitors had no hemodynamic effects but markedly reduced proteinuria in patients with chronic renal failure 8 and early diabetic nephropathy. 9 It has also been shown that monotherapy with spironolactone 10 or eplerenone, 11 a selective MR antagonist, is more effective than angiotensin-converting enzyme inhibitors in reducing proteinuria in hypertensive patients. Furthermore, White et al 12 showed that in hypertensive patients, eplerenone had a similar blood pressurelowering effect to that of a calcium antagonist, amlodipine, but reduced the urinary albumin-to-creatinine ratio to a greater extent.…”