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首页> 美国卫生研究院文献>Journal of Clinical Medicine >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
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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

机译：依普利农对阻塞性睡眠呼吸暂停和抵抗性高血压患者昼夜血压模式和左心室肥厚的影响-一项随机对照试验

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摘要

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 ( = 51) and the control group, remaining on their standard antihypertensive therapy ( = 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.
机译：阻塞性睡眠呼吸暂停（OSA）与各种重要的心血管结局如耐药性高血压（RAH）高度相关。尽管如此，到目前为止，对于OSA和RAH患者的夜间高血压（BP）与左心室肥大（LVH）之间的关系尚不完全清楚。这项研究的目的是评估在标准抗高血压治疗中加入依普利农对OSA和RAH患者24小时动态血压测量（ABPM）参数以及超声心动图和多导睡眠图的影响。将患者随机分为两个研究组之一：治疗组，口服50 mg / d依普利酮，为期6个月（= 51），对照组，继续接受标准降压治疗（= 51）。在那段时间之后，治疗组的夜间BP参数显着降低，包括夜间血压下降从4.6％升高到8.9％。此外，非北斗七星患者的数量减少了45.1％。治疗组还显示左心室肥大和呼吸暂停低通气指数（AHI）下降，这两个参数之间呈正相关。这项研究是第一个报告在向抗高血压治疗中添加选择性盐皮质激素受体拮抗剂后，OSA和RAH患者的昼夜节律变化和左心室几何结构改善的研究。

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