EFFECTS OF ESAXERENONE ON BLOOD PRESSURE, BAPWV AND CAROTID ARTERIAL ELASTICITY IN ESSENTIAL HYPERTENSIVE PATIENTS

Abstract

Abstract Objective: Esaxerenone is a novel nonsteroidal mineralocorticoid receptor blocker being developed for hypertension treatment. We investigated the effects of esaxerenone on blood pressure (BP), baPWV, and carotid arterial intima-media thickness (IMT) and elasticity in essential hypertension. Design and method: Forty hypertensive patients (twenty-five males, aged 67 years) were assigned to receive esaxerenone (2.5 mg once daily) for 12 weeks. The 20 patients were added on previous drugs with esaxerenone and for 20 patients currently medicated with eplerenone, esaxerenone was substituted for that. Changes in home BP, estimated glomerular filtration rate (eGFR), baPWV, central blood pressure (cSBP) were evaluated. The carotid arterial IMT and elastic modulus in the circumferential direction (Eq) were simultaneously measured by the high-resolution Doppler technique, “Phased Tracking Method”. Results: Esaxerenone reduced home BP (systolic/diastolic, 141.1 ± 13.2/79.6 ± 11.4 to 130.8 ± 11.0/74.6 ± 11.1mmHg), heart rate (72.7 ± 11.9 to 67.8 ± 8.1 bpm), cSBP (146.1 ± 27.7 to 136.5 ± 26.4 mmHg), baPWV (17245 ± 323 to 1595 ± 287 cm/sec) significantly (p < 0.05) after 12weeks in both groups. The significant reduction of home BP (systolic/diastolic,) in group A and B were seen (-14.0 ± 4.7/-5.4 ± 2.6 mmHg and -6.2 ± 2.5/-4.5 ± 2.2 mmHg, respectively). There were no significant changes in eGFR (67.8 ± 23.0 to 67.4 ± 19.3 mL/min/1.73m2) nor serum potassium (3.9 ± 0.7 to 4.1 ± 0.6mEq/L). Eq (720 ± 34 to 400 ± 44) was reduced significantly without changes in IMT. The histogram analysis of the Eq data revealed the drug decreased harder components of the elasticity distribution, suggesting improvement of endothelial dysfunction. Conclusions: These data demonstrate that once-daily esaxerenone provides potent antihypertensive and antiatherosclerotic effects.