OS 23-04 A NOVEL HORMONE THERAPY, DROSPIRENONE WITH ESTRADIOL FOR HYPERTENSIVE POSTMENOPAUSAL WOMEN: A SYSTEMIC REVIEW AND META-ANALYSIS

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Abstract

Objective:

To assess the efficacy and safety of a novel hormone therapy, drospirenone combined with 17-β-estradiol (DRSP/E2) in postmenopausal hypertensive women.

Design and Method:

A systemic literature search of PubMed, Embase, Cochrane Library, Web of Science (up to Oct. 2015) was performed. Studies were screened independently by two researchers according to the inclusion and exclusion criteria which included only the randomized controlled trials (RCT) about the drospirenone with 17-β-estradiol for postmenopausal women with hypertension. The methodological quality was evaluated by Cochrane handbook 5.1.0 and meta-analysis was conducted using RevMan 5.3.0 software.

Results:

Five RCTs involved 1121 patients who met the eligibility criteria. Clinical SBP and DBP of DRSP/E2 group reduced by −5.74/−2.61 mmHg (95% CI −7.67 to −3.82, P < 0.00001; 95% CI −3.82 to −1.41, P < 0.00001), which was statistically significant difference compared with placebo group. The meta-analysis of comparative studies found that the 24-h mean systolic blood pressure reduced −5.77 mmHg (95% CI −7.85 to −3.68, P < 0.00001) and the 24-h mean diastolic blood pressure reduced −3.59 mmHg (95% CI −4.92 to −2.27, P < 0.00001). Overall, DRSP/E2 group was superior in reducing clinical blood pressure (BP) and 24-h mean BP. There was no significant change in potassium levels on DRSP/E2 group versus control group, suggesting probability potassium sparing effect of this hormone therapy. The incidences of adverse events were low and similar.

Conclusions:

This meta-analysis demonstrates that a new hormone therapy with aldosterone receptor blocking activity, DRSP/3 mg combined E2/1 mg is effective for lowering clinical BP and 24-h ambulatory blood pressure in postmenopausal hypertensive women. All included participants could well tolerate this hormone therapy. In conclusion, data from recurrent studies support that DRSP/E2 is an effective and safe hormone combination therapy that could be used in postmenopausal hypertension.

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