Evidence map›Paper›PMID 18404673›Full record

ReviewClinical cardiology2008

A comparison of the aldosterone-blocking agents eplerenone and spironolactone.

Allan Struthers, Henry Krum, Gordon H Williams

Registry-linked trialOpen access · bronzeAbstract readComparative StudyReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Clinical cardiology, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03186742 (Effects of Eplerenone on Left Ventricular Hypertrophy in Patients With Resistant Hypertension and Obstructive Sleep Apnoea), which is not on this map. Cited by 99 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
99citing papers in PubMed, 3 pooled it
9.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03186742 phase4completednot on this mapstarted 2014, after this paper: background citation

Effects of Eplerenone on Left Ventricular Hypertrophy in Patients With Resistant Hypertension and Obstructive Sleep Apnoea

TypeinterventionalSponsorPoznan University of Medical SciencesRan2014 to 2017Enrolled125ConditionsHypertension,Essential, Obstructive Sleep Apnea, Left Ventricular HypertrophyArmsEplerenone 50 mg Tab
3 · Its place in the literature

Who cites it

99 citing papers in PubMed, 3 syntheses or guidelines pooled it, 263 citations in OpenAlex.

  1. Pooled it
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  3. Eplerenone for hypertension.The Cochrane database of systematic reviews · 2017
    Pooled it
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  19. Drug Repurposing: An Emerging Strategy inJournal of microbiology and biotechnology · 2025
    Review
  20. Article

39 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 3 countries.

Allan StruthersDivision of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee, UK. a.d.struthers@dundee.ac.uk
Henry Krum
Gordon H Williams
Brigham and Women's Hospital · USMonash University · AUNinewells Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Improved understanding of the adverse pharmacological properties of aldosterone has prompted investigation of the clinical benefits of blocking aldosterone at the receptor level. This article reviews the pharmacology, clinical efficacy, and tolerability of the two available blocking agents, spironolactone and eplerenone. A Medline search identified clinical studies assessing spironolactone and eplerenone. Priority was given to large, well-controlled, clinical trials and comparative studies. Pharmacological differences between spironolactone and eplerenone include lower affinity of eplerenone for progesterone, androgen, and glucocorticoid receptors; more consistently demonstrated nongenomic properties for eplerenone; and the presence of long-acting metabolites for spironolactone. Both agents effectively treat hypertension and heart failure but comparisons are complicated by the deficiency of head-to-head trials and differences between patient populations. There are differences in the tolerability profiles; spironolactone is associated with dose-dependent sexual side effects. Both agents produce dose-dependent increases in potassium concentrations, although the effect with spironolactone appears to be greater when both agents are administered at recommended doses. Choice of a specific agent should be based on individual patient issues, such as the nature of heart failure and patient concerns about adverse events.

Indexed as

EplerenoneHeart FailureHumansHypertensionMineralocorticoid Receptor AntagonistsSpironolactoneEplerenoneMineralocorticoid Receptor AntagonistsSpironolactone

Identifiers

PMID18404673
PMCPMC6652937
OpenAlexW2062266308

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.