System Evaluation In Accordance With Eplerenone Treatment Of Essential Hypertension

Objective To assess the efficacy of eplerenone for essential hypertension. Methods Included studies were randomized controlled trials of eplerenone versus placebo. Electronic search was applied to CENTRAL, published in the latest issue of the Cochrane Library, PubMed, MEDLINE, EMBASE, CINAHL ,Ovid, Medscape, TRIP, NRR, CBM. Hand searchs published and unpublished papers. Two independent reviewers extracted data. Trials were assessed for quality. RevMan4.2.7 software developed by the cochrane collaboration was used for meta-analysis. Results Nine related articles were identified, but only four with patients were eligible and were included in the systematic review. All articles were high quality, from developed countries. Eplerenone compared with placebo for clinic systolic BP,WMD=-9.23, 95%CI (-10.20, -8.26) ,p<0.00001; for clinic diastolic BP,WMD=-4.22, 95%CI(-4.90, -3.54) ,p<0.00001; for ABPM systolic BP, WMD=-8.13, 95%CI(-10.32, -5.94), p<0.00001; for ABPM diastolic BP,WMD=-5.24, 95%CI (-6.59, -3.89) ,p<0.00001; for totle adverse events, OR=0.91, 95%CI (0.53, 1.56), p=0.74. Conclusions Based on the review, eplerenone treatment significantly reduced blood pressure compared with placebo in patients with mild-to-moderate hypertension. Further large randomized, double blind, placebo- controlled trial are needed in long-term safety and efficacy and different subgroup of eplerenone.