Effectiveness of Eplerenone to Improve Target Organ Damage in Patients With Resistant Arterial Hypertension
Status:
Completed
Trial end date:
2008-07-01
Target enrollment:
Participant gender:
Summary
Resistant hypertension is defined as hypertension not controlled (i.e. blood pressure not
below 140/90 mmHg) with the use of adequate doses of at least three different
anti-hypertensives including a diuretic. Resistant hypertension is abundant. In the ALLHAT
trial 34% of patients did not reach the blood pressure goal of 140/90 mmHg. One possible
mechanism of resistance is the aldosterone-escape phenomenon.
During aldosterone escape, aldosterone plasma levels are normal or even elevated despite
therapy with ACEIs or ARBs. The prevalence is about 30-50%. Possible reasons for aldosterone
escape are alternative ways of aldosterone stimulation (hyperkalemia, adrenomedullin, ACTH),
local aldosterone production or primary aldosteronism. Aldosterone has deleterious blood
pressure independent effects on cardiac, vascular and renal damage.
Hypothesis: Eplerenone is effective to improve hypertensive target organ damage in patients
with resistant hypertension.