COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF ANTIHYPERTENSIVE THERAPY INCLUDING SPIRONOLACTONE AND EPLERENONE IN PATIENTS WITH ESSENTIAL HYPERTENSION WITH ATRIAL FIBRILLATION

Objective: To conduct a comparative analysis of the effectiveness of antihypertensive therapy including eplerenone and spironolactone in patients with essential hypertension with atrial fibrillation. Design and method: The study included 99 male and female patients with hypertension and a permanent form AF. The average age of the patients was 61.3±9.5 years, the average duration of hypertension was 12.9±8.3 years. Holter ECG monitoring was performed using a Cardiospy monitor (LABTECH LTD, Hungary) to verify atrial fibrillation. Statistical processing of the results was carried out in the Microsoft Excel 2010 database using the Statistica 10.0 program. The results of all studies were accepted as statistically significant at a p value of <0.05. Results: 99 patients were divided into 2 groups: first patients who completed 6 months of combined antihypertensive therapy with the inclusion of spironolactone (n=51), second patients who inclusion of eplerenone (n=48). Analysis of office blood pressure indicators showed good 6-month antihypertensive effectiveness in both groups, regardless of the treatment regimen. Group 1, SBP was initially 149.2±23.9 mmHg, and over time it was 126.5±14.5 mmHg. (p<0.001); DBP was 90.6±10.8 mm Hg. versus 79.6±7.4 mm Hg., respectively (p<0.001); the blood pressure value was 110.1±14.6 mm Hg. versus 95.2±8.9 mm Hg., respectively (p<0.001). Group 2, SBP was initially 147.6±24.9 mm Hg, and over time it was 122.2±12.4 (p<0.001); DBP was 91.1±13.2 mm Hg. versus 76.0±7.6 mm Hg., respectively (p<0.001); the blood pressure value was 109.9±16.4 mm Hg. versus 91.4±8.5 mmHg., respectively (p<0.001). Number of patients who achieved the target DBP level in the therapy group with the inclusion of eplerenone was significantly greater than in the therapy group with the inclusion of spironolactone: 87.8% versus 67.5%, respectively (χ2=4.08, p=0.043), patients who simultaneously achieved the target level of SBP and DBP was slightly greater in the therapy group with the inclusion of eplerenone than in the therapy group with inclusion of spironolactone: 100% versus 92.1%, respectively (χ2= 3.52, p=0.060). Conclusions: Thus, good antihypertensive efficacy was shown during 6 months of combination therapy with a significant advantage in achieving objective blood pressure levels in the group containing eplerenone compared to spironolactone.

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