Effect of eplerenone on serum levels of gene 2 expressed growth promoting factor in patients with arterial hypertension
Authors: Bilovol O. M. , Knyazkova I. I. , Holovachova V. O. , Kuzminova N. V. , Barbashova V. O. , Molodan D. V. , Bohun M. V. 
Published: January 2023

The aim of the work is to study the dynamics of diastolic function parameters, the content of the soluble growth factor receptor expressed by gene 2 (sST2) and the N-terminal fragment of brain natriuretic propeptide (NT-proBNP) in the blood of patients with hypertension when eplerenone is added to antihypertensive therapy.

Material and methods. 64 patients (average age 51.3±1.5 years) with stage II hypertension, grade 2, who did not take regular antihypertensive therapy, were examined. After registration of the initial data, 34 patients (group 1) were prescribed basic antihypertensive therapy for hypertension with the addition of the drug eplerenone (Epletor, Borshchagivskyi Zavod, Ukraine) at a dose of 25–50 mg per day for 3 months. Group 2 included 30 people who were prescribed basic hypertension therapy. The control group included 20 practically healthy people.

All subjects underwent a clinical and laboratory examination, including measurement of blood pressure (BP) in the office, during home self-monitoring and daily monitoring, echocardiography with assessment of transmitral Doppler blood flow, determination of sST2 and NT-proBNP levels in blood serum. Mathematical computer processing of the research results was carried out using the software package «Statistica 9.0» (Statsoft Inc, USA).

The results. After 3 months of treatment, a significantly greater decrease in SBP and DBP was established according to the data of «office» measurement, home self-monitoring and DMAT. A more pronounced positive dynamics of indicators of structural and geometric remodeling of the LV was noted in patients who received antihypertensive therapy with the addition of eplerenone. After a course of treatment, a significant increase in the E/A ratio by 33.3% (p<0.01) and a significant decrease in the E/e indicator by 31.3% (p<0.05) were noted in patients of group 1. At the same time, in patients of group 2, the change of E/A and E/e did not change reliably. It was found that in group 1, the serum concentration of sST2 significantly decreased by 29.5% (р<0.05) and was 28.4% (р<0.05) lower, compared to group 2, in which this indicator was practically not was changing A decrease in NT-proBNP was noted in patients of group 1 by 28.6% (p<0.01), which was 25.3% (p<0.01) less, compared to the data of group 2, where only a downward trend was noted of this indicator.

Conclusions. In patients with arterial hypertension of the 2nd degree, the addition of eplerenone to antihypertensive therapy contributes to a more pronounced decrease in blood pressure, measured by patients during self-control, during daily monitoring, compared to antihypertensive therapy. The inclusion of the selective mineralocorticoid receptor antagonist eplerenone in the complex therapy of patients with arterial hypertension of the 2nd degree has a pronounced positive effect on the structural and geometric indicators of the myocardium, the parameters of the diastolic function of the left ventricle, as well as the content of sST2 and NT-proBNP in the blood serum, along with good tolerability.