Evidence map›Paper›PMID 25125488›Full record

Trial reportDiabetes2015

Mineralocorticoid receptor blockade improves coronary microvascular function in individuals with type 2 diabetes.

Rajesh Garg, Ajay D Rao, Maria Baimas-George, Shelley Hurwitz, Courtney Foster, Ravi V Shah, Michael Jerosch-Herold, Raymond Y Kwong, Marcelo F Di Carli, Gail K Adler

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Diabetes, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05593055 (Mineralocorticoid Receptor, Coronary Microvascular Function, and Cardiac Efficiency in Hypertension), which is not on this map. Cited by 78 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 1 pooled it
9.0field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05593055 phase4recruitingnot on this mapstarted 2023, after this paper: background citation

Mineralocorticoid Receptor, Coronary Microvascular Function, and Cardiac Efficiency in Hypertension

TypeinterventionalSponsorBrigham and Women's HospitalRan2023 to 2027Enrolled75ConditionsHypertension, Left Ventricular HypertrophyArmsEplerenone, Chlorthalidone, Potassium
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 1 synthesis or guideline pooled it, 128 citations in OpenAlex.

  1. Pooled it
  2. Trial
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  9. Review
  10. Article
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  16. Review
  17. Cardiomodulatory Effects of Cardiometabolic and Antihyperglycemic Medications: The Roles of Oxidative and Endoplasmic Reticulum Stress.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025
    Review
  18. Review
  19. Article
  20. Adverse Effects of Aldosterone: Beyond Blood Pressure.Journal of the American Heart Association · 2024
    Review

18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Rajesh GargDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Ajay D RaoDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Maria Baimas-GeorgeDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Shelley HurwitzDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Courtney FosterDivision of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Ravi V ShahNoninvasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Michael Jerosch-HeroldDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Raymond Y KwongDivision of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Marcelo F Di CarliDivision of Nuclear Medicine and Molecular Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA Noninvasive Cardiovascular Imaging Program, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Gail K AdlerDivision of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA gadler@partners.org.
Brigham and Women's Hospital · US

Funding

Harvard Clinical and Translational Science Center (UL1)UL1TR000170 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2012 to 2013
$31.4M
TRAINING PROGRAM IN HYPERTENSIONT32HL007609 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI ADLER, GAIL KURR · 1985 to 2022
$10.2M
Role of Mineralocorticoid Receptor in Diabetic Cardiovascular DiseaseR01HL087060 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI ADLER, GAIL KURR · 2008 to 2011
$2.5M
Aldosterone and Diabetic Cardiovascular Disease: Research and Mentoring ProgamK24HL103845 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI ADLER, GAIL KURR · 2011 to 2021
$1.6M
NCATS NIH HHS UL1 TR000170NCATS NIH HHS UL-1TR-000170NHLBI NIH HHS K24 HL103845NHLBI NIH HHS K24-HL-103845NHLBI NIH HHS R01 HL087060NHLBI NIH HHS R01-HL-087060NHLBI NIH HHS T32 HL007609NHLBI NIH HHS T32-HL-007609
6 · The paper itself

Abstract

Reduced coronary flow reserve (CFR), an indicator of coronary microvascular dysfunction, is seen in type 2 diabetes mellitus (T2DM) and predicts cardiac mortality. Since aldosterone plays a key role in vascular injury, the aim of this study was to determine whether mineralocorticoid receptor (MR) blockade improves CFR in individuals with T2DM. Sixty-four men and women with well-controlled diabetes on chronic ACE inhibition (enalapril 20 mg/day) were randomized to add-on therapy of spironolactone 25 mg, hydrochlorothiazide (HCTZ) 12.5 mg, or placebo for 6 months. CFR was assessed by cardiac positron emission tomography at baseline and at the end of treatment. There were significant and similar decreases in systolic blood pressure with spironolactone and HCTZ but not with placebo. CFR improved with treatment in the spironolactone group as compared with the HCTZ group and with the combined HCTZ and placebo groups. The increase in CFR with spironolactone remained significant after controlling for baseline CFR, change in BMI, race, and statin use. Treatment with spironolactone improved coronary microvascular function, raising the possibility that MR blockade could have beneficial effects in preventing cardiovascular disease in patients with T2DM.

Indexed as

AdultAgedAngiotensin-Converting Enzyme InhibitorsCoronary CirculationDiabetes Mellitus, Type 2Diabetic AngiopathiesDiureticsDouble-Blind MethodDrug Therapy, CombinationEnalaprilFemaleHumansHydrochlorothiazideMaleMicrocirculationMiddle AgedAngiotensin-Converting Enzyme InhibitorsDiureticsEnalaprilHydrochlorothiazideMineralocorticoid Receptor AntagonistsSpironolactone

Identifiers

PMID25125488
PMCPMC4274801
OpenAlexW2152397139

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.