{"title":"依沙塞隆对老年原发性醛固酮增多症患者的降压作用。","authors":"Masanori Fujimoto, Suzuka Watanabe, Katsushi Igarashi, Yutaro Ruike, Kazuki Ishiwata, Kumiko Naito, Akiko Ishida, Masaya Koshizaka, Sawako Suzuki, Yuki Shiko, Hisashi Koide, Koutaro Yokote","doi":"10.1155/2023/6453933","DOIUrl":null,"url":null,"abstract":"<p><strong>Design: </strong>Retrospective cohort study. <i>Patients</i>. The data was obtained from a total of 87 PA patients treated with esaxerenone. The treatment group comprised 33 patients who received esaxerenone as first-line therapy and 54 patients that switched from another MRA to esaxerenone. <i>Measurements</i>. Blood pressure (BP), plasma aldosterone concentration (PAC), plasma renin activity (PRA), serum potassium level, estimated glomerular filtration rate (eGFR), urinary albumin-creatinine ratio (UACR), and brain natriuretic peptide (BNP) were assessed before and after treatment with esaxerenone. Patients with overall reductions in their systolic or diastolic BP by 10 mmHg, or more, were considered responders. Unpaired <i>t</i>-tests of the biochemical and personal parameters between responders and nonresponders were run to find the most influencing characteristic for treatment success.</p><p><strong>Results: </strong>BP overall decreased after treatment with esaxerenone (systolic BP: <i>P</i>=0.025, diastolic BP: <i>P</i>=0.096). Serum potassium levels increased, while eGFR decreased (<i>P</i>=0.047 and 0.043, respectively). No patients needed a dose reduction or treatment discontinuation of esaxerenone based on the serum potassium and eGFR criteria. UACR and BNP decreased insignificantly. The responders were significantly older than the nonresponders of the esaxerenone treatment (<i>P</i>=0.0035).</p><p><strong>Conclusions: </strong>Esaxerenone was effective in older patients with primary aldosteronism.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2023 ","pages":"6453933"},"PeriodicalIF":1.9000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9873463/pdf/","citationCount":"1","resultStr":"{\"title\":\"Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism.\",\"authors\":\"Masanori Fujimoto, Suzuka Watanabe, Katsushi Igarashi, Yutaro Ruike, Kazuki Ishiwata, Kumiko Naito, Akiko Ishida, Masaya Koshizaka, Sawako Suzuki, Yuki Shiko, Hisashi Koide, Koutaro Yokote\",\"doi\":\"10.1155/2023/6453933\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Design: </strong>Retrospective cohort study. <i>Patients</i>. The data was obtained from a total of 87 PA patients treated with esaxerenone. The treatment group comprised 33 patients who received esaxerenone as first-line therapy and 54 patients that switched from another MRA to esaxerenone. <i>Measurements</i>. Blood pressure (BP), plasma aldosterone concentration (PAC), plasma renin activity (PRA), serum potassium level, estimated glomerular filtration rate (eGFR), urinary albumin-creatinine ratio (UACR), and brain natriuretic peptide (BNP) were assessed before and after treatment with esaxerenone. Patients with overall reductions in their systolic or diastolic BP by 10 mmHg, or more, were considered responders. Unpaired <i>t</i>-tests of the biochemical and personal parameters between responders and nonresponders were run to find the most influencing characteristic for treatment success.</p><p><strong>Results: </strong>BP overall decreased after treatment with esaxerenone (systolic BP: <i>P</i>=0.025, diastolic BP: <i>P</i>=0.096). Serum potassium levels increased, while eGFR decreased (<i>P</i>=0.047 and 0.043, respectively). No patients needed a dose reduction or treatment discontinuation of esaxerenone based on the serum potassium and eGFR criteria. UACR and BNP decreased insignificantly. The responders were significantly older than the nonresponders of the esaxerenone treatment (<i>P</i>=0.0035).</p><p><strong>Conclusions: </strong>Esaxerenone was effective in older patients with primary aldosteronism.</p>\",\"PeriodicalId\":14132,\"journal\":{\"name\":\"International Journal of Hypertension\",\"volume\":\"2023 \",\"pages\":\"6453933\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9873463/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Hypertension\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/6453933\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Hypertension","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/6453933","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism.
Design: Retrospective cohort study. Patients. The data was obtained from a total of 87 PA patients treated with esaxerenone. The treatment group comprised 33 patients who received esaxerenone as first-line therapy and 54 patients that switched from another MRA to esaxerenone. Measurements. Blood pressure (BP), plasma aldosterone concentration (PAC), plasma renin activity (PRA), serum potassium level, estimated glomerular filtration rate (eGFR), urinary albumin-creatinine ratio (UACR), and brain natriuretic peptide (BNP) were assessed before and after treatment with esaxerenone. Patients with overall reductions in their systolic or diastolic BP by 10 mmHg, or more, were considered responders. Unpaired t-tests of the biochemical and personal parameters between responders and nonresponders were run to find the most influencing characteristic for treatment success.
Results: BP overall decreased after treatment with esaxerenone (systolic BP: P=0.025, diastolic BP: P=0.096). Serum potassium levels increased, while eGFR decreased (P=0.047 and 0.043, respectively). No patients needed a dose reduction or treatment discontinuation of esaxerenone based on the serum potassium and eGFR criteria. UACR and BNP decreased insignificantly. The responders were significantly older than the nonresponders of the esaxerenone treatment (P=0.0035).
Conclusions: Esaxerenone was effective in older patients with primary aldosteronism.
期刊介绍：
International Journal of Hypertension is a peer-reviewed, Open Access journal that provides a forum for clinicians and basic scientists interested in blood pressure regulation and pathophysiology, as well as treatment and prevention of hypertension. The journal publishes original research articles, review articles, and clinical studies on the etiology and risk factors of hypertension, with a special focus on vascular biology, epidemiology, pediatric hypertension, and hypertensive nephropathy.
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