EVIDENCE-BASED USE OF EPLERENONE
https://doi.org/10.17650/1818-8338-2012-1-81-85
Abstract
Data of the negative effect of high concentrations of aldosterone in the blood for cardiovascular disease, which served as the theoretical basis for wider use in clinical practice of the drugs belonging to the class of aldosterone receptor blockers is presented. Evidence-based data on efficacy and safety of aldosterone receptor blockers, which were obtained in the course of several randomized clinical trials is performed. Particular attention is paid to aspects of the clinical use of selective aldosterone receptor blocker eplerenone, including current data, which makes reasonable extension of indications for its use in treating patients with chronic heart failure. Data on indications of eplerenone use in patients with hypertension, especially in the case of associated target organ damage is presented.
About the Authors
S. R. Gilyarevski
Sklifosovsky Institute of Emergency Surgery;
Russian Federation
Russian Federation
V. A. Orlov
РМАПО
Russian Federation
Department of Clinical Pharmacology and Therapeutics
Russian Federation
Department of Clinical Pharmacology and Therapeutics
I. M. Kuzmina
Sklifosovsky Institute of Emergency Surgery;
Russian Federation
Russian Federation
M. V. Golshmid
РМАПО
Russian Federation
Department of Clinical Pharmacology and Therapeutics
Russian Federation
Department of Clinical Pharmacology and Therapeutics
G. Y. Zakharova
РМАПО
Russian Federation
Department of Clinical Pharmacology and Therapeutics
Russian Federation
Department of Clinical Pharmacology and Therapeutics
I. I. Sinitsina
РМАПО
Russian Federation
Department of Clinical Pharmacology and Therapeutics
Russian Federation
Department of Clinical Pharmacology and Therapeutics
References
1. Connell J. Aldosterone — the future challenge in cardiovascular disease? Br J Diabet Vasc Dis 2004;4:370−6.
2. Mortensen R.M., Williams G.H. Aldosterone action. In: Endocrinology, 4th ed. DeGroot L.J., Jameson J.L. eds. Philadelphia, PA: WB Saunders, 2001; p. 1783−9.
3. Davies J.O., Freeman R.H. Historical perspectives on the renin-angiotensinaldosterone system and angiotensin blockade. Am J Cardiol 1982;49:1385−9.
4. Wehling M. Aldosterone specific membrane receptors, rapid activation of the sodiumhydrogen
5. exchanger, and cardiovascular implications. Cardiovasc Res 1995;29:167−71.
6. Wang W. Chronic administration of aldosterone depresses baroreceptor reflex function in the dog. Hypertension 1994; 24:571−5.
7. Schmidt B.M.W., Montealegre A., Janson C.P. et al. Short term cardiovascular effects of aldosterone in healthy male volunteers. J Endocrinol Metab 1999;84:3528−33.
8. Tanabe A., Naruse M., Naruse K. et al. Left ventricular hypertrophy is more prominent in patients with primary aldosteronism than in patients with other types of secondary hypertension. Hypertens Res 1997;20:8590.
9. Rocha R., Stier C.T. Jr., Kifor I. et al. Aldosterone: a mediator of myocardial necrosis and renal arteriopathy. Endocrinology 2000;141:3871−8.
10. Rocha R., Chander P.N., Khanna K. et al. Mineralocorticoid blockade reduces vascular injury in stroke-prone hypertensive rats. Hypertens 1998;31:451−8.
11. Sun Y., Zhang J., Lu L. Aldosteroneinduced inflammation in the rat heart: role of oxidative stress. Am J Pathol 2002;161:1773−81.
12. Yamamoto K., Burnett J.C., Jougasaki M. et al. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy. Hypertension 1996;28:988−94.
13. Weber K.T., Villarreal D. Aldosterone and antialdosterone therapy in congestive heart failure. Am J Cardiol 1993;71:3−11.
14. Cleland J.G.F., Dargie H.J., Hodsman G.P. Captopril in heart failure. A double blind controlled trial. Br Heart J 1984;52:530−5.
15. Staessen J., Lijnen P., Fagard R. et al. Rise in plasma concentration of aldosterone during long‑term angiotensisn II suppression. J Endocrinol 1981;91:457−65.
16. McKelvie R.S., Yusuf S., Pericak D. et al. for the RESOLVD Pilot Study Investigators. Comparison of candesartan, enalapril, and their combination in congestive heart failure. Circulation 1999;100:1056−64.
17. Pitt B., Zannad F., Remme W.J. et al. for the Randomized Aldactone Evaluation Study Investigators. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999;341:709−17.
18. Pitt B., Remme W., Zannad F., et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003;348:1309−21.
19. Bozkurt B., Agoston I., Knowlton A.A. Complications of inappropriate use of spironolactone in heart failure: when an old medicine spirals out of new guidelines. J Am Coll Cardiol 2003;41:211−4.
20. Zannad F., McMurray J.J., Krum H. et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 2011;364(1):11−21.
21. Pitt B., Reichek N., Willenbrock R. et al. Effects of eplerenone, enalapril, and eplerenone/enalapril in patients with essential hypertension and left ventricular hypertrophy: the 4E‑left ventricular hypertrophy study. Circulation 2003;108:1831−8.
Review
For citations:
Gilyarevski S.R., Orlov V.A., Kuzmina I.M., Golshmid M.V., Zakharova G.Y., Sinitsina I.I. EVIDENCE-BASED USE OF EPLERENONE. The Clinician. 2012;6(1):81-85. (In Russ.) https://doi.org/10.17650/1818-8338-2012-1-81-85
Views:
883
Email this article 