Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism
Context. Esaxerenone is a new mineralocorticoid receptor antagonist (MRA). It is an oral nonsteroidal MRA with high MR-binding specificity and antihypertensive effects in patients with essential hypertension and primary aldosteronism (PA). This study aimed to investigate the underlying characteristi...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | International Journal of Hypertension |
| Online Access: | http://dx.doi.org/10.1155/2023/6453933 |
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| _version_ | 1849309295134375936 |
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| author | Masanori Fujimoto Suzuka Watanabe Katsushi Igarashi Yutaro Ruike Kazuki Ishiwata Kumiko Naito Akiko Ishida Masaya Koshizaka Sawako Suzuki Yuki Shiko Hisashi Koide Koutaro Yokote |
| author_facet | Masanori Fujimoto Suzuka Watanabe Katsushi Igarashi Yutaro Ruike Kazuki Ishiwata Kumiko Naito Akiko Ishida Masaya Koshizaka Sawako Suzuki Yuki Shiko Hisashi Koide Koutaro Yokote |
| author_sort | Masanori Fujimoto |
| collection | DOAJ |
| description | Context. Esaxerenone is a new mineralocorticoid receptor antagonist (MRA). It is an oral nonsteroidal MRA with high MR-binding specificity and antihypertensive effects in patients with essential hypertension and primary aldosteronism (PA). This study aimed to investigate the underlying characteristics of PA patients who responded best to an esaxerenone treatment. 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. |
| format | Article |
| id | doaj-art-18e93074285741809185da8abbef5db5 |
| institution | Kabale University |
| issn | 2090-0392 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Hypertension |
| spelling | doaj-art-18e93074285741809185da8abbef5db52025-08-20T03:54:12ZengWileyInternational Journal of Hypertension2090-03922023-01-01202310.1155/2023/6453933Antihypertensive Effects of Esaxerenone in Older Patients with Primary AldosteronismMasanori Fujimoto0Suzuka Watanabe1Katsushi Igarashi2Yutaro Ruike3Kazuki Ishiwata4Kumiko Naito5Akiko Ishida6Masaya Koshizaka7Sawako Suzuki8Yuki Shiko9Hisashi Koide10Koutaro Yokote11Department of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyBiostatistics SectionDepartment of Endocrinology, Hematology and GerontologyDepartment of Endocrinology, Hematology and GerontologyContext. Esaxerenone is a new mineralocorticoid receptor antagonist (MRA). It is an oral nonsteroidal MRA with high MR-binding specificity and antihypertensive effects in patients with essential hypertension and primary aldosteronism (PA). This study aimed to investigate the underlying characteristics of PA patients who responded best to an esaxerenone treatment. 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.http://dx.doi.org/10.1155/2023/6453933 |
| spellingShingle | Masanori Fujimoto Suzuka Watanabe Katsushi Igarashi Yutaro Ruike Kazuki Ishiwata Kumiko Naito Akiko Ishida Masaya Koshizaka Sawako Suzuki Yuki Shiko Hisashi Koide Koutaro Yokote Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism International Journal of Hypertension |
| title | Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism |
| title_full | Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism |
| title_fullStr | Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism |
| title_full_unstemmed | Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism |
| title_short | Antihypertensive Effects of Esaxerenone in Older Patients with Primary Aldosteronism |
| title_sort | antihypertensive effects of esaxerenone in older patients with primary aldosteronism |
| url | http://dx.doi.org/10.1155/2023/6453933 |
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