The velocity of home blood pressure reduction in response to low-dose eplerenone combined with other antihypertensive drugs determined by exponential decay function analysis |
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Authors: | Noha Elnagar Michihiro Satoh Miki Hosaka Kei Asayama Kazuki Ishikura Taku Obara |
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Affiliation: | 1. Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science
SendaiJapan;2. Department of Pharmacy, Tohoku University Hospital
SendaiJapan;3. Department of Cardiovascular Diseases, Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, University of LeuvenBelgium;4. Department of Pharmacy, Hachinohe City Hospital
HachinoheJapan;5. Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization
Tohoku University
SendaiJapan |
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Abstract: | Background/objective: Eplerenone is a highly selective aldosterone blocker, which has the potential to lower blood pressure (BP) in patients with hypertension. The objective of this study was to assess the hypotensive effects of low-dose eplerenone (25?mg) using home BP measurements. We also assessed the time required to reach 95% of the maximum antihypertensive effect (stabilization time) by analyzing exponential decay functions using home BP measurements.Methods: We reviewed the medical records of 83 hypertensive patients who were taking eplerenone 25?mg (age, 68.6?±?11.8?years; men, 36.1%) in addition to other antihypertensive agents. Home BPs were averaged in each patient for the last 5?days of each observation period. The morning versus evening effect (M/E ratio) and the evening versus morning effect (E/M ratio) were calculated to assess the duration of action of eplerenone.Results: The mean home systolic/diastolic BPs at baseline were 136.8?±?8.8/77.2?±?9.3?mmHg, respectively. After 8?weeks of treatment with eplerenone, home systolic/diastolic BP significantly decreased by ?7.1?±?10.1/?2.6?±?5.0?mmHg (p?0.0001). The time for stabilization of home systolic and diastolic BPs was 13.7?days (p?=?0.006) and 16.5 days (p?=?0.001), respectively. When eplerenone was administered in the morning, the M/E ratio was 1.1?±?0.3. The corresponding E/M ratio for evening administration was 0.9?±?0.6. Although no nocturia was observed, there was a slight but significant increase in serum potassium levels (p?=?0.03).Conclusions: Our data suggest that the combination of eplerenone with other antihypertensive drugs may be a promising therapeutic strategy for the treatment of essential hypertension. |
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Keywords: | Combination therapy eplerenone exponential decay function home blood pressure measurements maximal effect stabilization time |
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