The effect of eplerenone and losartan on arterial stiffness and central arterial pressure in patients with mild to moderate essential hypertension

Objective To investigate the effect of eplerenone and losartan on arterial stiffness and central arterial pressure (CAP) in patients with mild to moderate essential hypertension. Methods A randomized, double-blind, double imitation and positive drug paralledl-controlled trial was designed. Eighty-four patients with mild-to-moderate of essential hypertension (DBP 90-110 mm Hg and SBP 140-180 mm Hg) were divided into eplerenone group and losartan group (n=42, respectively). Every patient in both groups took the placebo for 2 weeks and then was administrated eplerenone or losartan 50 mg every day in the following 12 weeks. All patients visited hospital every 2 weeks. If DBP≥90 mm Hg 4 weeks later, the dose was increased (eplerenone 50 mg taken orally twice a day or losartan 100 mg qd). When the 2 weeks' placebo and 12 weeks' trial had been completed, the function of liver and kidneys, the blood electrolytes, the blood glucose, the blood lipids, the complete blood cell count, the routine urine test and the ambulant blood pressure monitor (ABPM), brachial-arm pulse wave velocity (baPWV) and CAP of every patients were detected. Results Five patients in the eplerenone group and 2 patients in the losartan group were lost to follow up. By comparison with pre-treatment, the seated SBP and DBP, the ABPM parameters, the baPWV and CAP in two groups decreased after 12 weeks' treatment respectively, but there was no difference existing in the two groups' decreased range of the seated SBP and DBP[(18.3±8.6) vs (21.4±9.4), (14.0±5.3) vs (15.1±6.6)mm Hg, all P0.05]. There was not significant difference in 24 hours' average SBP and DBP, the average SBP and DBP at daytime, the average SBP and DBP at nighttime, baPWV, CAP and the total incidence of adverse effect between the two groups (all P0.05). Conclusion Both eplerenone and losartan can significantly reduce arterial stiffness and central arterial pressure of patients with mild-|moderate essential hypertension.