Journal of the American Society of Hypertension
Volume 2, Issue 6 , Pages 462-468 , November 2008

Effectiveness of the selective aldosterone blocker, eplerenone, in patients with resistant hypertension

  • David A. Calhoun, MD

      Affiliations

    • University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
    • ,
  • William B. White, MD

      Affiliations

    • Division of Hypertension and Clinical Pharmacology, Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, Connecticut, USA
    • Corresponding Author InformationCorresponding author: William B. White, MD, Professor and Chief, Division of Hypertension and Clinical Pharmacology, Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, Connecticut 06030. Tel: 860-679-2104; fax: 860-679-1250

Received 25 March 2008 ,Accepted 13 May 2008.

References 

  1. Calhoun DA. Resistant or difficult-to-treat hypertension. J Clin Hypertens. 2006;8:181–186
  2. Moser M, Setaro J. Clinical practice (Resistant or difficult-to-control hypertension). N Engl J Med. 2006;355:385–392
  3. Epstein M, Calhoun DA. The role of aldosterone in resistant hypertension: implications for pathogenesis and treatment. Curr Hypertens Rep. 2007;9:98–105
  4. Mansoor GA, White WB. Circadian blood pressure variation in hypertensive patients with primary hyperaldosteronism. Hypertension. 1998;31:843–847
  5. Rose LI, Underwood RH, Newmark SR, Kisch ES, Williams GH. Pathophysiology of spironolactone-induced gynecomastia. Ann Intern Med. 1977;87:398–403
  6. Lee TH. Spironolactone and gynecomastia. Harvard Heart Lett. 2003;14:3
  7. De Gasparo M, Joss U, Ramjoue HP, Whitebread SE, Haenni H, Schenkel L, et al. Three new epoxy-spironolactone derivatives: characterization in vivo and in vitro. J Pharmacol Exp Ther. 1987;240:650–656
  8. White WB, Carr AA, Krause S, Jordan R, Roniker B, Oigman W. Assessment of the novel selective aldosterone blocker eplerenone using ambulatory and clinical blood pressure in patients with systemic hypertension. Am J Cardiol. 2003;92:38–42
  9. White WB, Duprez D, St Hillaire R, Krause S, Roniker B, Kuse-Hamilton J, et al. Effects of the selective aldosterone blocker eplerenone versus the calcium antagonist amlodipine in systolic hypertension. Hypertension. 2003;41:1021–1026
  10. Krum H, Nolly H, Workman D, He W, Roniker B, Krause S, et al. Efficacy of eplerenone added to renin-angiotensin blockade in hypertensive patients. Hypertension. 2002;40:117–123
  11. Weinberger MH, White WB, Ruilope LM, MacDonald TM, Davidson RC, Roniker B, et al. Effects of eplerenone versus losartan in patients with low-renin hypertension. Am Heart J. 2005;150:426–433
  12. Flack JM, Oparil S, Pratt JH, Roniker B, Garthwaite S, Kleiman JH, et al. Efficacy and tolerability of eplerenone and losartan in hypertensive black patients and white patients. J Am Coll Cardiol. 2003;41:1156–1158
  13. White WB, Viadero JJ, Lane TJ, Podesla S. Effects of combination therapy with captopril and nifedipine in severe or resistant hypertension. Clin Pharmacol Ther. 1986;39:43–48
  14. White WB. Ambulatory blood pressure monitoring as an investigative tool for characterizing resistant hypertension and its rational treatment. J Clin Hypertens. 2007;9:25–30
  15. White WB, Giles TG, Bakris GL, Neutel J, Davidai G, Weber MA. Measuring the efficacy of antihypertensive therapy by ambulatory blood pressure monitoring in the primary care setting. Am Heart J. 2006;151:176–184
  16. Cockcroft D, Gault MD. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41
  17. Goodwin J, Bilous M, Winship S, Finn P, Jones SC. Validation of the Oscar 2 oscillometric 24-hour ambulatory blood pressure monitor according to the British Hypertension Society protocol. Blood Press Monit. 2007;12:113–117
  18. White WB, Mehotra D, Black HR, Fakouhi TD. Effects of controlled-onset extended-release verapamil on nocturnal blood pressure (dippers versus nondippers) (COER-Verapamil Study Group). Am J Cardiol. 1997;80:469–474
  19. Black HR, Bakris GL, Weber MA, Weiss R, Shahawy ME, Marple R, et al. Efficacy and safety of darusentan in patients with resistant hypertension: results from a randomized, double-blind, placebo-controlled dose-ranging study. J Clin Hypertens. 2007;9:760–769
  20. Ouzan J, Perault C, Lincoff AM, Carre E, Mertes M. The role of spironolactone in the treatment of patients with refractory hypertension. Am J Hypertens. 2002;15:333–339
  21. Nishizaka M, Zaman MA, Calhoun DA. Efficacy of low-dose spironolactone in subjects with resistant hypertension. Am J Hypertens. 2003;16:925–930
  22. Chapman N, Dobson J, Wilson S, Dahlof B, Sever PS, Wedel H, et al. Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension. 2007;49:839–845
  23. Menard J. The 45-year story of the development of an anti-aldosterone more specific than spironolactone. Mol Cell Endocrinol. 2004;217:45–52
  24. Pitt B, Reichek N, Willenbrock R, Zannad F, Phillips R, Roniker B, et al. Effects of eplerenone, enalapril, and eplerenone and enalapril in patients with essential hypertension and left ventricular hypertrophy: the 4E left ventricular hypertrophy study. Circulation. 2003;108:1831–1838
  25. Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348:1309–1321
  26. Lane DA, Beevers DG. Amiloride 10 mg is less effective than spironolactone 25 mg in patients with hypertension resistant to a multidrug regime including an angiotensin receptor blocking agent. J Hypertens. 2007;25:2515–2516

 This article was supported by Pfizer, Inc (IIR no. 2004-0619) and by an unrestricted, investigator-initiated research Grant from University of Connecticut Health Center Clinical Trials Unit, Farmington, Connecticut.

 Dr. Calhoun has served as a consultant to Novartis and is a member of the Pfizer speaker's bureau. Dr. White has served as a consultant to Pfizer on the topic of cardiovascular effects of arthritis therapies.

PII: S1933-1711(08)00093-4

doi: 10.1016/j.jash.2008.05.005

Journal of the American Society of Hypertension
Volume 2, Issue 6 , Pages 462-468 , November 2008

Article Tools

* Image Usage & Resolution