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Eplerenone lowers blood pressure in patients with primary hypertension. [9] Eplerenone also reduces arterial stiffness and vascular endothelial dysfunction. [10] For persons with resistant hypertension, eplerenone is safe and effective for reducing blood pressure, [11] particularly in persons with resistant hypertension due to ...
[214] Patients taking spironolactone must be monitored for side effects including dizziness, headache, fatigue, diarrhea, hypertriglyceridemia and elevated liver enzymes. [215] [216] Other activities of spironolactone may include very weak interactions with the estrogen and progesterone receptors and agonism of the pregnane X receptor.
Spironolactone has been identified as an inhibitor of NRG1‐ERBB4 signaling. [142] Spironolactone has been found to act as a potent inhibitor of the pannexin 1 channel, and this action appears to be involved in its antihypertensive effects independently of MR antagonism. [143] Spironolactone has been found to block hERG channels. [144]
eplerenone; spironolactone; Aldosterone receptor antagonists are not recommended as first-line agents for blood pressure, [47] but spironolactone and eplerenone are both used in the treatment of heart failure and resistant hypertension.
Potassium-sparing diuretics act to prevent sodium reabsorption in the collecting tubule by either binding ENaCs (amiloride, triamterene) or by inhibiting aldosterone receptors (spironolactone, eplerenone). This prevents excessive excretion of K + in urine and decreased retention of water, preventing hypokalemia. [10]
Antihypertensive agents comprise multiple classes of compounds that are intended to manage hypertension (high blood pressure). Antihypertensive therapy aims to maintain a blood pressure goal of <140/90 mmHg in all patients, as well as to prevent the progression or recurrence of cardiovascular diseases (CVD) in hypertensive patients with established CVD. [2]
Spironolactone has a long half-life and is excreted 47-51% through kidneys. Patients with chronic kidney disease therefore require close monitoring when taking the drug. Spironolactone is also eliminated through feces (35-41%). The excretion of eplerenone is 67% through kidneys and 32% through feces.
Resistant hypertension: add spironolactone ACC / AHA 2017 [13] General <130/80 BP > 130/80: Lifestyle changes and monotherapy with thiazide-type diuretic, ACEI/ARB, and/or CCB BP >20/10 above target: Lifestyle changes and two from different classes: thiazide-type diuretic, ACEI/ARB, and/or CCB JNC 8 2013 [1] General age ≥60 General age <60 ...