Eplerenone is a new, more selective aldosterone receptor antagonist that may avoid the progestational and antiandrogenic side effects of spironolactone in the treatment of cardiovascular conditions.
May improve tolerability of aldosterone blockade in CV disease; leaves open need for head-to-head outcome trials versus spironolactone.
Data from animal studies and clinical trials indicate that aldosterone causes cardiovascular and renal injury through mineralocorticoid receptor-dependent mechanisms. However, although aldosterone receptor antagonism reduces mortality in patients with congestive heart failure, the progestational and antiandrogenic side effects of the nonspecific aldosterone receptor antagonist, spironolactone, have limited its usefulness in the treatment of hypertension. This review provides an overview of the pharmacology, efficacy, and safety of a new, more selective aldosterone receptor antagonist, eplerenone, in the context of emerging concepts of the role of aldosterone in cardiovascular toxicity.
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Nancy J. Brown (2003) studied this question.
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