The velocity of home blood pressure reduction in response to low-dose eplerenone combined with other antihypertensive drugs determined by exponential decay function analysis.

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.