Angiotensin II receptor blocker combined with eplerenone or hydrochlorothiazide for hypertensive patients with diabetes mellitus
Abstract
Experimental models recently suggested an interaction between aldosterone and adipose tissue, but clinical investigation has been limited. We studied the effects of eplerenone compared to hydrochlorothiazide (HCTZ) on blood pressure (BP), glucose, and lipid levels in 50 patients with essential hypertension (EHT) and type 2 diabetes mellitus whose BP failed to reach target levels with 8 mg of candesartan alone. BP improved similarly in both groups over the 12-month study period, but BMI, waist circumference, and LDL-cholesterol were decreased in the eplerenone group, while glycohemoglobin was elevated in the HCTZ group.
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There is clinical inertia in treating residual hypertension among people with type 2 diabetes.
“There appears to be inertia to treat residual hypertension in persons with T2D, and pharmacotherapy should be intensified when needed to achieve BP goals.”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [247]
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Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.08.002 · Cited by 507 · see citing works
- Authors
- Karashima, S., Yoneda, T., Kometani, M., Ohe, M., Mori, S., Sawamura, T., Furukawa, K., Yamagishi, M., & Takeda, Y.
- Affiliations
- Kanazawa University (JP)
- Kanazawa Hospital (JP)
- Corresponding author
- Karashima, Shigehiro
- ORCID
- Venue
- Clinical and Experimental Hypertension
- Publisher
- Informa UK Limited
- Published
- 2016-09-20
- Volume
- 38
- Issue
- 7
- Pages
- 565-570
- ISSN
- 0148-3927 (ISSN-L)
- 1064-1963
- 1525-6006
- OpenAlex
- W2521231344
- Cited by
- 15
- References
- 5
- Citations by year
- 2025: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2018: 2 · 2017: 1
- FWCI
- 0.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical and Experimental Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japanese Health and Labor Sciences Research Grant (H26-nanchisei-027)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- angiotensin receptor blockers, eplerenone, hydrochlorothiazide, essential hypertension, type 2 diabetes, candesartan, aldosterone, adipose tissue, blood pressure control, glycohemoglobin, LDL cholesterol, waist circumference, body mass index
- MeSH terms
- Essential Hypertension, Eplerenone, Adult, Aged, Mineralocorticoid Receptor Antagonists, Antihypertensive Agents, Benzimidazoles, Biphenyl Compounds, Blood Pressure, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Female, Glycated Hemoglobin, Humans, Hydrochlorothiazide, Hypertension, Male, Middle Aged, Spironolactone, Tetrazoles, Treatment Outcome, Drug Monitoring, Angiotensin Receptor Antagonists
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