依普利酮（Inspra）疗效怎么样？

Eplerenone (alias: Inspra) has definite efficacy in the treatment of hypertension, heart failure and myocardial infarction. It has fewer adverse reactions and is well tolerated. It is a good alternative to spironolactone. How effective is eplerenone (Inspra)?

The efficacy of eplerenone in treating hypertension:

The FDA has approved eplerenone for use in stable patients with left ventricular systolic dysfunction (ejection fraction <40%) and congestive heart failure after acute myocardial infarction (MI) to improve survival.

Eplerenone is the first aldosterone receptor blocker approved for this indication. The FDA's approval was based on the results of the EPHESUS (Eplerenone Efficacy and Survival Study in Heart Failure After Acute Myocardial Infarction) trial. In patients with heart failure after myocardial infarction, eplerenone plus standard care reduced mortality by 15% compared with placebo and standard care (ACE inhibitors and beta-blockers).

The outstanding advantage of eplerenone (alias: Inspra) is that 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. For patients with severe heart failure and myocardial infarction, eplerenone combined with angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers can improve quality of life and reduce mortality.

Advantages of treatment with eplerenone (also known as: Inspra):

1. For the treatment of heart failure after acute myocardial infarction, combined use with standard treatment drugs can reduce the total mortality rate in the treatment group by 15% (P=0.008);

2. Eplerenone and enalapril are equally effective in reversing left ventricular hypertrophy and hypertension, with less cough side effects, and the combined effect is more obvious;

3. There are few adverse reactions. Except for the adverse reaction of elevated blood potassium, other adverse reactions are no different from the placebo group;

4. Eplerenone has almost no sex hormone-related side effects of spironolactone.