ECE2024 Poster Presentations Adrenal and Cardiovascular Endocrinology (95 abstracts)
Comparison of antihypertensive effects between eplerenone and esaxerenone, mineralocorticoid receptor antagonists, in patients with primary aldosteronism
Satoshi Morimoto , Saya Takebe , Kentaro Oyake , Saori Kitayama , Makiko Ikemoto , Yuko Inoue , Hisashi Sano , Kiyotaka Hirata , Noriyoshi Takano , Kaoru Yamashita , Yasufumi Seki , Kanako Bokuda , Daisuke Watanabe & Atsuhiro Ichihara
Tokyo Women’s Medical University, Department of Internal Medicine, Tokyo, Japan
Objective: The efficacy of mineralocorticoid receptor (MR) antagonists has been demonstrated in MR-related hypertension, including primary aldosteronism (PA). Non-inferiority in 24-hour blood pressure reduction has been shown for esaxerenone 2.5 mg/day compared to eplerenone 50 mg/day in patients with essential hypertension. However, no trial has compared the antihypertensive effects of these drugs in patients with PA. This study aimed to investigate the effect of switching from eplerenone to esaxerenone and assess changes in various parameters, including blood pressure.
Methods: Patients with PA receiving eplerenone for at least 8 weeks underwent a switch to esaxerenone at 1/20th of the dose. Blood pressure measurements (office, 24-hour ambulatory blood pressure monitoring [ABPM]) and urine and blood tests were conducted before and 12 weeks after the switch, and the obtained data were compared before and after the switch.ResultsForty-seven cases (21 males) with a mean age of 58±12 years and body mass index of 23.8 (21.7–25.3) kg/m2 were included. Office blood pressure before the switch was 137±18/81±11 mmHg, 24-hour blood pressure 130 (123–140)/82±6 mmHg, diurnal blood pressure 133 (126–142)/84±6 mmHg, nocturnal blood pressure 119 (110–126)/73±6 mmHg, serum potassium 4.2±0.3 mEq/l, eGFR 70.1±14.3 ml/min per 1.73 m2, and plasma renin activity (PRA) 0.9 (0.5–1.7) ng/mL per hour. After the switch, office systolic blood pressure was significantly decreased [130 (118–139) mmHg; p=0.002]. ABPM revealed significant reductions in both systolic and diastolic blood pressure over 24 h [127 (120–137) mmHg; P=0.008/80±6 mmHg; P=0.006], during the diurnal period [133 (126–142) mmHg; P=0.015/82±7 mmHg; P=0.009], and throughout the nocturnal period [115 (110–119) mmHg; p=0.039/71±7 mmHg; P=0.023]. Serum potassium did not show significant changes, but PRA [1.5 (0.7–2.1) ng/ml per hour; P<0.001] increased significantly, and eGFR (64.9±14.8 ml/min per 1.73 m2; P<0.001) significantly decreased.
Conclusion: In PA patients, esaxerenone demonstrated a stronger MR antagonistic effect and a significant and sustained antihypertensive effect compared to eplerenone.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more