依普利酮对高血压的效果

(Inspra) was approved for clinical use by the State Food and Drug Administration in 2002. It has definite efficacy in the treatment of hypertension, heart failure and myocardial infarction. Eplerenone is safe and well tolerated, and is a good alternative to spironolactone.

The commonly used domestic aldosterone receptor antagonist spironolactone has a significant protective effect on the cardiovascular system, but its sex hormone-related side effects limit its application. Eplerenone, as a new generation of selective aldosterone receptor antagonist, provides a new method for the treatment of cardiovascular diseases.

The EPHESUS trial showed that for patients with left ventricular ejection fraction (LVEF) <40% and heart failure within 3 to 14 days after myocardial infarction, adding eplerenone (Inspra) to standard treatment can reduce all-cause death by 15%, primary combined endpoint events (cardiovascular death or hospitalization due to cardiovascular events) by 17%, and sudden cardiac death (sudden cardiac death) by 21%. cardiac death, SCD).

The combination of eplerenone and enalapril can significantly reduce left ventricular weight, and the addition of hydrochlorothiazide and amlodipine can further reduce it. Previous studies have confirmed that left ventricular mass index is associated with event-free survival. In studies on patients with diabetes mellitus and proteinuria, both eplerenone (Inspra) and enalapril can reduce systolic blood pressure and diastolic blood pressure, while eplerenone reduces the urinary albumin/inosine ratio UACR more significantly than enalapril.

As the first selective aldosterone receptor antagonist, it has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of hypertension. The "China Hypertension Prevention and Treatment Guidelines 2010" also proposed eplerenone as one of the main antihypertensive drugs.

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