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Effectiveness of Eplerenone to Improve Target Organ Damage in Patients With Resistant Arterial Hypertension

Phase 3
Completed
Conditions
Essential Hypertension
Interventions
Drug: placebo
Registration Number
NCT00138944
Lead Sponsor
University of Erlangen-Nürnberg Medical School
Brief 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.

Detailed Description

see above

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
85
Inclusion Criteria
  • Casual blood pressure >=140/90 despite effective triple therapy including an ACEI/ARB and a diuretic
Exclusion Criteria
  • Contraindication for eplerenone
  • Creatinine-Clearance < 60 ml/min
  • Diabetes mellitus

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1placeboPlacebo
2eplerenoneEplerenone
Primary Outcome Measures
NameTimeMethod
Change of left ventricular mass3 months vs. baseline

MRT assessment of left ventricular mass

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

CRC Medical Department IV

🇩🇪

Erlangen, Germany

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