Antialbuminuric effect of eplerenone in comparison to thiazide diuretics in patients with hypertension

J Clin Hypertens (Greenwich). 2017 Oct;19(10):990-998. doi: 10.1111/jch.13054. Epub 2017 Aug 28.

Abstract

This study investigated the effects and safety of eplerenone or thiazide diuretics in patients with hypertension and albuminuria (pretreatment urinary albumin/creatinine ratio ≥10 mg/gCr) treated with an angiotensin II receptor blocker. The primary end point was the mean percent change in the urinary albumin/creatinine ratio from baseline to 48 weeks. An efficacy analysis was performed in 195 patients (98 in the eplerenone group and 97 in the thiazide group). Systolic and diastolic blood pressures at 48 weeks were similar in the two groups. The mean percent change in the urinary albumin/creatinine ratio from baseline to 48 weeks was similar in the two groups (P=.804). In the safety analysis, the withdrawal rates for adverse events were similar in both groups. The antialbuminuric effects and safety of eplerenone therapy were similar to those of thiazide diuretics when combined with an angiotensin II receptor blocker in patients with hypertension and albuminuria.

Keywords: antihypertensive therapy; clinical trials; combination therapy; proteinuria; renal disease.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Albuminuria / drug therapy*
  • Albuminuria / etiology
  • Angiotensin Receptor Antagonists / adverse effects
  • Angiotensin Receptor Antagonists / pharmacology
  • Antihypertensive Agents / pharmacology
  • Blood Pressure / drug effects
  • Creatinine / blood
  • Eplerenone
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Male
  • Middle Aged
  • Mineralocorticoid Receptor Antagonists / adverse effects
  • Mineralocorticoid Receptor Antagonists / pharmacology
  • Prospective Studies
  • Serum Albumin, Human / drug effects*
  • Serum Albumin, Human / urine
  • Sodium Chloride Symporter Inhibitors / administration & dosage
  • Sodium Chloride Symporter Inhibitors / adverse effects
  • Sodium Chloride Symporter Inhibitors / pharmacology*
  • Spironolactone / administration & dosage
  • Spironolactone / adverse effects
  • Spironolactone / analogs & derivatives*
  • Spironolactone / pharmacology

Substances

  • Angiotensin Receptor Antagonists
  • Antihypertensive Agents
  • Mineralocorticoid Receptor Antagonists
  • Sodium Chloride Symporter Inhibitors
  • Spironolactone
  • Eplerenone
  • Creatinine
  • Serum Albumin, Human