降压药依普利酮效果怎么样？

How effective are antihypertensive drugs?

Eplerenone was first launched in the United States in 2004. It is suitable for essential hypertension and heart failure after myocardial infarction. For severe hypertension that cannot be controlled by a combination of multiple antihypertensive drugs, the addition of eplerenone can significantly reduce blood pressure, especially the decrease in systolic blood pressure is more significant. Combined treatment with angiotensin-converting enzyme inhibitors (ACEI) and receptor blockers can improve patients' quality of life and reduce mortality in severe heart failure and myocardial infarction.

The safety and effectiveness of eplerenone alone and in combination with other antihypertensive drugs were evaluated in 3091 patients with hypertension. 46% of the subjects were female, 14% were black, and 22% were elderly. Subjects with elevated baseline serum potassium and elevated baseline serum creatinine were excluded from the study.

Two fixed-dose, placebo-controlled, 8- to 12-week monotherapy studies were conducted to evaluate the antihypertensive efficacy of eplerenone in patients with baseline diastolic blood pressure of 95 to 114 mmHg. In both studies, 61 patients were randomized to the eplerenone group and 140 patients were randomized to the placebo group. Patients receive 25 to 400 mg of eplerenone once or twice a day.

Patients who received eplerenone (50-200 mg daily) had significantly lower sitting systolic blood pressure and diastolic blood pressure. Compared with the placebo group, the systolic blood pressure was reduced by 6-13mmHg, and the diastolic blood pressure was reduced by 3-7mmHg.

In these studies, the analysis results of 24-hour ABPM data showed that eplerenone (eplerenone) once or twice a day can maintain the antihypertensive effect throughout the entire medication cycle, and eplerenone 50 mg twice a day has a better antihypertensive effect than once a day.

The antihypertensive effect can appear within 2 weeks of taking the medicine. Eplerenone can be used in combination with angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, calcium antagonists, alpha-blockers, and hydrochlorothiazide. And the average heart rate did not change significantly in those who took the medicine together. There were also no effects of eplerenone on heart rate, QRS interval, PR interval, or QT interval.

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