Aldosterone Blockade to Prevent Myocardial Remodeling In Patients With Controlled Essential Hypertension

Aldosterone Blockade to Prevent Myocardial Remodeling In Patients With Controlled Essential Hypertension

The goal of this project is to investigate the effects that the addition of aldosterone blockade with eplerenone will have on the progression of diastolic dysfunction in patients with controlled essential hypertension.

The purpose of this project is to determine if eplerenone, an aldosterone blocker, prevents remodelling of the heart in patients with controlled essential hypertension, defined as having a blood pressure of equal to or less than 130/80 in diabetics and equal to or less than 140/90 in non-diabetics. This study will investigate if the addition of 25 milligrams of eplerenone daily to a subject's hypertension medication regimen will prevent the progression or development of diastolic dysfunction. Echocardiography will be used to measure the changes in heart structure of subjects receiving eplerenone versus subjects receiving placebo (a drug that may resemble the study drug but contains no active ingredient). Approximately 30 subjects will take part in this study.

Inclusion Criteria:

• Treated and controlled hypertension
• Less than 140/90 in non-diabetics
• Less than 130/80 in diabetics

Exclusion Criteria:

• currently receiving an aldosterone blocker
• clinical evidence of congestive heart failure
• prior myocardial infarction
• renal dysfunction with a creatinine clearance of less than 40ml/min
• serum potassium > 5.5meq/L at initiation
• concomitant use of a medication that inhibits the CYP3A4 enzyme (ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir)