ReviewAmerican journal of hypertension2017
Use of Aldosterone Antagonists for Treatment of Uncontrolled Resistant Hypertension.
Review in American journal of hypertension, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04515095 (A Safety and Feasibility Study of Water-only Fasting and Refeeding for Treatment of Stage 1 and 2 Hypertensive Patients), which is not on this map. Cited by 27 papers.
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.
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.
A Safety and Feasibility Study of Water-only Fasting and Refeeding for Treatment of Stage 1 and 2 Hypertensive Patients
Who cites it
27 citing papers in PubMed, 49 citations in OpenAlex.
- Effect of Sequential Nephron Blockade versus Dual Renin-Angiotensin System Blockade Plus Bisoprolol in the Treatment of Resistant Hypertension, a Randomized Controlled Trial (Resistant Hypertension on Treatment - ResHypOT).Vascular health and risk management · 2022Trial
- Spironolactone and Resistant Hypertension in Heart Failure With Preserved Ejection Fraction.American journal of hypertension · 2018Trial
- Targeting the aldosterone-mineralocorticoid receptor pathway in cardiovascular-kidney-metabolic syndrome.Nature reviews. Nephrology · 2026Review
- The Adipokine Hypothesis of Heart Failure With a Preserved Ejection Fraction: A Novel Framework to Explain Pathogenesis and Guide Treatment.Journal of the American College of Cardiology · 2025Review
- Alterations in glucocorticoid homeostasis following sleeve gastrectomy.bioRxiv : the preprint server for biology · 2025Article
- Mineralocorticoid receptor antagonists and heart failure with preserved ejection fraction: current understanding and future prospects.Heart failure reviews · 2025Review
- The Effect of Aldosterone on Cardiorenal and Metabolic Systems.International journal of molecular sciences · 2023Review
- Nonsteroidal Mineralocorticoid Receptor Antagonism by Finerenone-Translational Aspects and Clinical Perspectives across Multiple Organ Systems.International journal of molecular sciences · 2022Review
- Review
- Salt Sensitivity of Blood Pressure in Blacks and Women: A Role of Inflammation, Oxidative Stress, and Epithelial NaAntioxidants & redox signaling · 2021Review
- Immune Mechanisms of Dietary Salt-Induced Hypertension and Kidney Disease: Harry Goldblatt Award for Early Career Investigators 2020.Hypertension (Dallas, Tex. : 1979) · 2021Review
- Obesity, kidney dysfunction, and inflammation: interactions in hypertension.Cardiovascular research · 2021Review
- Home Blood Pressure Control and Drug Prescription Patterns among Thai Hypertensives: A 1-Year Analysis of Telehealth Assisted Instrument in Home Blood Pressure Monitoring Nationwide Pilot Project.International journal of hypertension · 2021Article
- Hypothesis: Unrecognized actions of ENaC blockade in improving refractory-resistant hypertension and residual cardiovascular risk.International Journal of Cardiology. Hypertension · 2020Article
- Role of Hyperinsulinemia and Insulin Resistance in Hypertension: Metabolic Syndrome Revisited.The Canadian journal of cardiology · 2020Review
- The endothelial mineralocorticoid receptor: Contributions to sex differences in cardiovascular disease.Pharmacology & therapeutics · 2019Review
- [Austrian Consensus on High Blood Pressure 2019].Wiener klinische Wochenschrift · 2019Article
- Obesity, kidney dysfunction and hypertension: mechanistic links.Nature reviews. Nephrology · 2019Review
- Sex-specific responses to mineralocorticoid receptor antagonism in hypertensive African American males and females.Biology of sex differences · 2019Article
- The renin-angiotensin system in cardiovascular autonomic control: recent developments and clinical implications.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2019Review
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMultiple studies indicate that primary aldosteronism (PA) is common in patients with resistant hypertension, with an estimated prevalence of approximately 20%. Additional studies suggest that beyond this 20% of patients with classical PA, there is a larger proportion of patients with lesser degrees of hyperaldosteronism which contributes even more broadly to antihypertensive treatment resistance. Given these observations, it is intuitive that use of aldosterone antagonists will provide antihypertensive benefit in patients with resistant hypertension and evidence of aldosterone excess. Intriguingly, however, are clinical findings demonstrating substantive benefit of aldosterone antagonists in patients with resistant hypertension, but without demonstrative evidence of hyperaldosteronism, that is, with seemingly normal or even low aldosterone levels.
conclusionSpironolactone is clearly established as the most effective fourth agent for treatment of uncontrolled resistant hypertension. Emerging observations suggest a further role of spironolactone for counteracting the effects of diet high in sodium, particularly in obese, hypertensive patients.
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What OpenQuestion holds
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.