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Open AccessArticle

The Effects of Eplerenone on the Circadian Blood Pressure Pattern and Left Ventricular Hypertrophy in Patients with Obstructive Sleep Apnea and Resistant Hypertension—A Randomized, Controlled Trial

1
Department of Hypertension, Angiology and Internal Disease, Poznan University of Medical Sciences, 61-848 Poznan, Poland
2
Department of Pulmonology, Allergology and Lung Oncology, Poznan University of Medical Sciences, 61-001 Poznan, Poland
3
Department of Environmental Medicine, Poznan University of Medical Sciences, 60-806 Poznan, Poland
4
Bad Oeynhausen, Heart and Diabetes Center NRW, Ruhr-University of Bochum, 32545 Bad Oeynhausen, Germany
5
Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-848 Poznan, Poland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(10), 1671; https://doi.org/10.3390/jcm8101671
Received: 28 August 2019 / Revised: 25 September 2019 / Accepted: 3 October 2019 / Published: 13 October 2019
The obstructive sleep apnea (OSA) is highly associated with various significant cardiovascular outcomes such as resistant hypertension (RAH). Despite this, as of now the relationship between high night-time blood pressure (BP) and left ventricular hypertrophy (LVH) in patients with OSA and RAH is not fully understood. The aim of this study was to assess the influence of the addition of eplerenone to a standard antihypertensive therapy on parameters of 24-h ambulatory blood pressure measurement (ABPM) as well as on the results of echocardiography and polysomnography in patients with OSA and RAH. The patients were randomly assigned to one of the two study groups: the treatment group, receiving 50 mg/d eplerenone orally for 6 months (n = 51) and the control group, remaining on their standard antihypertensive therapy (n = 51). After that period, a significant reduction in the night-time BP parameters in the treatment group including an increased night blood pressure fall from 4.6 to 8.9% was noted. Additionally, the number of non-dipper patients was reduced by 45.1%. The treatment group also revealed a decrease in left ventricular hypertrophy and in the apnea–hypopnea index (AHI) with a positive correlation being observed between these two parameters. This study is the first to report the improvement of the circadian BP profile and the improvement of the left ventricle geometry in patients with OSA and RAH following the addition of selective mineralocorticoid receptor antagonists to antihypertensive therapy. View Full-Text
Keywords: obstructive sleep apnea; resistant hypertension; non-dippers; mineralocorticoid receptor antagonists; eplerenone; left ventricular hypertrophy obstructive sleep apnea; resistant hypertension; non-dippers; mineralocorticoid receptor antagonists; eplerenone; left ventricular hypertrophy
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Krasińska, B.; Cofta, S.; Szczepaniak-Chicheł, L.; Rzymski, P.; Trafas, T.; Paluszkiewicz, L.; Tykarski, A.; Krasiński, Z. The Effects of Eplerenone on the Circadian Blood Pressure Pattern and Left Ventricular Hypertrophy in Patients with Obstructive Sleep Apnea and Resistant Hypertension—A Randomized, Controlled Trial. J. Clin. Med. 2019, 8, 1671.

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