依普利酮在治疗高血压这方面疗效如何？

Inspra was first approved for marketing in the United States in 2002 for the treatment of patients with hypertension. Clinical trials have proven that eplerenone can also be used for congestive heart failure after acute myocardial infarction. However, eplerenone has not been officially approved for marketing in my country, so many patients are still unclear about its effect. Let's take a look at the efficacy of eplerenone in treating hypertension?

Eplerenone binds to mineralocorticoid receptors, thereby blocking the binding of aldosterone, a component of the renin-angiotensin-aldosterone system (RAAS). Eplerenone has a stronger antagonizing effect on aldosterone than spironolactone, and has extremely low affinity for androgen and progesterone receptors, with few adverse reactions and almost no sex hormone-related side effects of spironolactone.

In a study on systolic hypertension in the elderly, 269 patients were treated with eplerenone Inspra (50-200) mg daily and amlodipine (2.5-10) mg daily. The results showed that both drugs had the same effect in lowering systolic blood pressure, while amlodipine lowered diastolic blood pressure more significantly. In terms of target organ protection, both drugs improved carotid-femoral and carotid-radial pulse rates after 24 weeks of treatment. In terms of the incidence of adverse reactions, 19.9% ​​of the amlodipine group developed peripheral edema, while only 2.7% of the eplerenone group developed hyperkalemia. 0.4% of the amlodipine group developed hyperkalemia, and 0.9% of the eplerenone group developed hyperkalemia.

The FDA has previously approved it for use in patients with stable left ventricular systolic dysfunction (ejection fraction <40%) and congestive heart failure after acute myocardial infarction (MI) to improve survival rates. The approval was based on the results of the EPHESUS (Eplerenone Efficacy and Survival in Heart Failure After Acute Myocardial Infarction Study) trial. In patients with heart failure after myocardial infarction, eplerenone Inspra plus standard care reduced mortality by 15% compared with placebo and standard care (ACE inhibitors and beta-blockers).

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