Second-Generation Aldosterone Synthase Inhibitors for Hypertension: A Bayesian Meta-Analysis of Randomized Trials - PubMed
5 hours ago
- #hypertension
- #aldosterone-synthase inhibitors
- #meta-analysis
- Second-generation aldosterone-synthase inhibitors (ASIs) show promise as a novel treatment for hypertension.
- A Bayesian meta-analysis of 8 randomized controlled trials (n=3,371) assessed ASIs (baxdrostat, lorundrostat, vicadrostat).
- ASIs significantly reduced systolic blood pressure (SBP) by -6.7 mm Hg and diastolic blood pressure by -2.09 mm Hg compared to placebo.
- Hypertensive urgency was less frequent with ASIs (OR: 0.36).
- No significant difference in all-cause mortality or adrenal insufficiency was observed between ASIs and placebo.
- ASIs increased risks of hyperkalemia (OR: 7.1), hyponatremia (OR: 2.6), and hypotension (OR: 3.28).
- Subgroup analysis showed high probability of clinically meaningful SBP reduction with baxdrostat (87.5%) and lorundrostat (94.3%).
- The study concludes ASIs are effective for blood pressure reduction but carry risks of electrolyte imbalances and hypotension.