Blockade of aldosterone in the treatment of arterial hypertension (aspects of the use of eplerenone)
Gurevich M.A., Kuzmenko N.A.

Moscow Regional Research and Clinical Institute named after M.F. Vladimirskiy

In recent years there is more and more data on the role of aldosterone in the human body. The article shows that a prolonged increase in aldosterone concentration affects the level of blood pressure, leads to the development of complications of vascular diseases, heart and kidney diseases, as well as to metabolic disorders; promotes the reabsorption of sodium and the excretion of potassium and hydrogen ions; increases free radical oxidation, leading to the development of inflammation, remodeling, apoptosis and fibrosis. Antagonists of mineralocorticoid receptors - spironolactone and eplerenone are used for the treatment of arterial hypertension and, especially, in the treatment of resistant arterial hypertension. The article deals with modern aspects of the clinical use of eplerenone, a selective antagonist of mineralocorticoid receptors, in the treatment of patients with cardiovascular diseases. The evidence base for the use of eplerenone in the treatment of patients with various diseases is given. The aspects of the safe use of mineralocorticoid receptors antagonists are discussed. The advantages of using eplerenone in comparison with spironolactone are given in terms of reducing the incidence of possible side effects. The effects of eplerenone in the therapy of patients with AH are shown in many randomized clinical trials and on the basis of own experience.

Key words: aldosterone, arterial hypertension, complications, eplerenone, combined use, arterial hypertension resistant to treatment.
For citation: Gurevich M.A., Kuzmenko N.A. Blockade of aldosterone in the treatment of arterial hypertension (aspects of the use of eplerenone) // RMJ. 2017. № 11. P. 776–779.