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

J Hum Hypertens. 2025 Jun;39(6):462-464. doi: 10.1038/s41371-025-01021-9. Epub 2025 May 3.

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.

Publication types

  • Meta-Analysis

MeSH terms

  • Antihypertensive Agents* / therapeutic use
  • Blood Pressure* / drug effects
  • Cytochrome P-450 CYP11B2* / antagonists & inhibitors
  • Enzyme Inhibitors* / therapeutic use
  • Humans
  • Hypertension* / blood
  • Hypertension* / drug therapy
  • Hypertension* / physiopathology
  • Mineralocorticoid Receptor Antagonists* / pharmacology
  • Mineralocorticoid Receptor Antagonists* / therapeutic use
  • Randomized Controlled Trials as Topic
  • Renin* / blood

Substances

  • Antihypertensive Agents
  • Cytochrome P-450 CYP11B2
  • Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists
  • Renin