The Effects of Eplerenone on the Circadian Blood Pressure Pattern and Left Ventricular Hypertrophy in Patients with Obstructive Sleep Apnea and Resistant Hypertension-A Randomized, Controlled Trial
| Autor: | Piotr Rzymski, Tomasz Trafas, Szczepan Cofta, Beata Krasińska, Ludwina Szczepaniak-Chicheł, Lech Paluszkiewicz, Andrzej Tykarski, Zbigniew Krasiński |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
lcsh:Medicine Polysomnography 030204 cardiovascular system & hematology Left ventricular hypertrophy Article law.invention 03 medical and health sciences 0302 clinical medicine non-dippers Randomized controlled trial law Internal medicine medicine 030212 general & internal medicine Circadian rhythm mineralocorticoid receptor antagonists eplerenone obstructive sleep apnea medicine.diagnostic_test business.industry lcsh:R resistant hypertension General Medicine medicine.disease Eplerenone left ventricular hypertrophy Obstructive sleep apnea Blood pressure medicine.anatomical_structure Ventricle Cardiology business medicine.drug |
| Zdroj: | Journal of Clinical Medicine Journal of Clinical Medicine, Vol 8, Iss 10, p 1671 (2019) Volume 8 Issue 10 |
| ISSN: | 2077-0383 |
| Popis: | The obstructive sleep apnea (OSA) is highly associated with various significant cardiovascular outcomes such as resistant hypertension (RAH). Despite this, as of now the relationship between high night-time blood pressure (BP) and left ventricular hypertrophy (LVH) in patients with OSA and RAH is not fully understood. The aim of this study was to assess the influence of the addition of eplerenone to a standard antihypertensive therapy on parameters of 24-h ambulatory blood pressure measurement (ABPM) as well as on the results of echocardiography and polysomnography in patients with OSA and RAH. The patients were randomly assigned to one of the two study groups: the treatment group, receiving 50 mg/d eplerenone orally for 6 months (n = 51) and the control group, remaining on their standard antihypertensive therapy (n = 51). After that period, a significant reduction in the night-time BP parameters in the treatment group including an increased night blood pressure fall from 4.6 to 8.9% was noted. Additionally, the number of non-dipper patients was reduced by 45.1%. The treatment group also revealed a decrease in left ventricular hypertrophy and in the apnea&ndash hypopnea index (AHI) with a positive correlation being observed between these two parameters. This study is the first to report the improvement of the circadian BP profile and the improvement of the left ventricle geometry in patients with OSA and RAH following the addition of selective mineralocorticoid receptor antagonists to antihypertensive therapy. |
| Databáze: | OpenAIRE |
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