依普利酮的功效与作用

(Inspra) is the first selective aldosterone receptor antagonist. It has been used to treat hypertension and left ventricular dysfunction after acute myocardial infarction. It can effectively lower blood pressure, improve cardiac function, and reduce myocardial damage. Eplerenone selectively acts on aldosterone receptors and is highly selective on mineralocorticoid receptors, but has less effect on androgen and progesterone receptors. Its affinity for mineralocorticoids is 15 to 20 times that of spironolactone, while its affinity for androgen and progesterone receptors is 500 times smaller than that of spironolactone, so sex hormone-related adverse reactions are less likely to occur.

Eplerenone’s efficacy and effects:

In a study of systolic hypertension in the elderly, 269 patients were treated with eplerenone (Inspra) daily (50-200) mg 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.

(Inspra) combined with 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 and enalapril can reduce systolic blood pressure and diastolic blood pressure, but eplerenone reduces the urinary albumin/inosine ratio UACR more significantly than enalapril.

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