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Blood pressure response to mineralocorticoid receptor antagonists or aldosterone synthase inhibitors according to baseline renin levels

Journal of Human Hypertension volume 39, pages 462–464 (2025)Cite this article

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Abstract

Plasma renin is a surrogate marker of sodium retention in hypertension, and its levels are suppressed in conditions of heightened aldosterone production. We performed a random-effects meta-analysis of randomized clinical trials focusing on the impact of mineralocorticoid receptor antagonists (MRA) and aldosterone synthase inhibitors (ASi) on blood pressure according to baseline renin levels. We included four randomized clinical trials, and we found that the response to MRA or ASi was independent of baseline plasma renin levels.

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Fig. 1: Effects of mineralocorticoid receptor antagonists/aldosterone synthase inhibitors by renin category.

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The data underlying this article will be shared on reasonable request to the corresponding author.

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Authors and Affiliations

  1. RISE-Health, Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal

    Ana Rita Leite, António Angélico-Gonçalves, Adelino Leite-Moreira, João Sérgio Neves & João Pedro Ferreira

  2. Department of Endocrinology, Diabetes and Metabolism, São João Local Health Unit, Porto, Portugal

    Ana Rita Leite & João Sérgio Neves

  3. Department of Cardiology, Gaia e Espinho Local Health Unit, Vila Nova de Gaia, Porto, Portugal

    António Angélico-Gonçalves

  4. Centre d’Investigations Cliniques Plurithématique 1433, INSERM, Université de Lorraine, Nancy, France

    João Pedro Ferreira

Authors
  1. Ana Rita Leite
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  2. António Angélico-Gonçalves
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  3. Adelino Leite-Moreira
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  4. João Sérgio Neves
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  5. João Pedro Ferreira
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Contributions

ARL and JPF conceived and designed the study. ALM, JSN and JPF provided methodological and statistical advice. ARL and AAG drafted the first version of the manuscript. All authors provided clinical feedback in interpreting the results, contributed critically to subsequent revisions, and approved the final version of the manuscript.

Corresponding author

Correspondence to Ana Rita Leite.

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The authors declare no competing interests.

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Leite, A.R., Angélico-Gonçalves, A., Leite-Moreira, A. et al. Blood pressure response to mineralocorticoid receptor antagonists or aldosterone synthase inhibitors according to baseline renin levels. J Hum Hypertens 39, 462–464 (2025). https://doi.org/10.1038/s41371-025-01021-9

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