In a new study, researchers found promise in combining two new classes of medication into a treatment regimen for patients with heart disease.
Currently, a primary course of treatment for patients with heart failure or resistant high blood pressure is a class of medications called steroidal mineralocorticoid receptor antagonists (s-MRA), chiefly spironolactone.
S-MRAs work by blocking the body’s reabsorption of sodium, leading to increased fluid excretion.
S-MRAs are effective at reducing heart failure-related mortality or hospitalization.
The World Health Organization includes spironolactone on its List of Essential Medicines as a heart failure treatment.
However, s-MRAs can cause high blood potassium, a dangerous and potentially fatal complication.
Because of this, many physicians are hesitant to begin treatment with s-MRAs or discontinue treatment within several months, leaving patients again at risk of the complications of heart failure.
A newer class of mineralocorticoid receptor antagonists—nonsteroidal mineralocorticoid receptor antagonists (ns-MRSs)—is entering the market and is currently under evaluation for efficacy and side-effects.
Thus far, ns-MRAs appear at least as effective as s-MRAs with lower rates of elevated blood potassium.
In addition to ns-MRAs, new drugs working as potassium-lowering agents are also now available.
They replace older potassium-lowering drugs that were rarely used because they could cause the death of bowel tissue.
The team notes that the development of new ns-MRAs and the availability of new potassium-lowering agents hold the promise of further improving cardiovascular outcomes in patients with heart failure, chronic renal disease, diabetes mellitus and/or resistant hypertension.
One researcher of the study is Cardiologist Bertram Pitt, MD.
The study was presented at the American Physiological Society (APS) Aldosterone and ENaC in Health and Disease: The Kidney and Beyond Conference.
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