Why the study?
Does eplerenone compared to hydrochlorothiazide improve blood pressure, glucose, and lipid levels in patients with essential hypertension and type 2 diabetes mellitus uncontrolled on candesartan?
Does eplerenone compared to hydrochlorothiazide improve blood pressure, glucose, and lipid levels in patients with essential hypertension and type 2 diabetes mellitus uncontrolled on candesartan?
In diabetic patients with hypertension uncontrolled on candesartan, adding eplerenone provides similar blood pressure reduction to hydrochlorothiazide but with a more favorable metabolic profile.
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Eplerenone was associated with similar BP control but better metabolic parameters than HCTZ; hypothesis-generating in diabetic hypertension, requires RCTs.
Experimental models recently suggested an interaction between aldosterone and adipose tissue, but clinical investigation has been limited. We studied the effects of eplerenone compared to hydrochlorothiazide (HCTZ) on blood pressure (BP), glucose, and lipid levels in 50 patients with essential hypertension (EHT) and type 2 diabetes mellitus whose BP failed to reach target levels with 8 mg of candesartan alone. BP improved similarly in both groups over the 12-month study period, but BMI, waist circumference, and LDL-cholesterol were decreased in the eplerenone group, while glycohemoglobin was elevated in the HCTZ group.
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Karashima et al. (2016) studied this question.
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