SynthesisJournal of human hypertension2024
Efficacy and safety of mineralocorticoid receptor antagonists for the treatment of low-renin hypertension: a systematic review and meta-analysis.
Synthesis in Journal of human hypertension, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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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.
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Who cites it
30 citing papers in PubMed, 31 citations in OpenAlex.
- Bilateral Adrenal Primary Aldosteronism Is Uniformly Present in Hypertensive Afro-Caribbean First-Generation Immigrants to Western Canada.Journal of the American Heart Association · 2026Article
- Race and Ancestry in Primary Aldosteronism.Journal of the American Heart Association · 2026Article
- Mechanisms for Mineralocorticoid-Driven Age-Related Hypertension: Potential Therapeutic Role of Mineralocorticoid Receptor Antagonists and Aldosterone Synthase Inhibitors.Circulation research · 2026Review
- Sex differences in the renal T cell profile in DOCA-salt hypertension are independent of MR activation and increases in blood pressure.American journal of physiology. Renal physiology · 2026Article
- Prevalence, clinical characteristics and management of low-renin hypertension: a real-world cohort study.Journal of human hypertension · 2026Article
- Low-renin hypertension in incidental adrenal adenomas and response to aldosterone-targeted therapy: a prospective study.European journal of internal medicine · 2026Article
- Consensus on the management of hypertension in individuals with diabetes by Asian-Pacific Society of hypertension (APSH) & Diabetes Asia Study Group (DASG).Journal of human hypertension · 2026Article
- Renin-Guided Risk Stratification and Therapy in Hypertension to Reduce Major Adverse Cardiovascular Outcomes.medRxiv : the preprint server for health sciences · 2026Article
- Is It Time to Retire Aldosterone Suppression Testing?American journal of hypertension · 2026Review
- Intensive blood pressure control in heart failure with preserved ejection fraction: a symptom-modifying strategy.Heart failure reviews · 2026Review
- Driving hypertension: non-classic apparent mineralocorticoid excess.Nature reviews. Endocrinology · 2026Article
- Postural test to differentiate primary aldosteronism from low-renin hypertension: a retrospective single-center study.Journal of endocrinological investigation · 2026Article
- Beyond Blood Pressure: Salt Sensitivity as a Cardiorenal Phenotype-A Narrative Review.Life (Basel, Switzerland) · 2026Review
- GWAS and Replication Analysis of Apparent Treatment-Resistant Hypertension.Hypertension (Dallas, Tex. : 1979) · 2026Article
- The Role of Mineralocorticoid Receptors in the Treatment of Primary Hypertension.Current hypertension reports · 2026Review
- Comparing Efficacy and Safety of Different Aldosterone Synthase Inhibitors for Hypertension: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.Clinical Medicine Insights. Cardiology · 2026Article
- Excess dietary potassium raises blood pressure in male mice by an aldosterone-dependent increase in ENaC.Communications biology · 2025Article
- Screening and Diagnosis Trends for Primary Aldosteronism: A Longitudinal Nationwide Cohort Study of 7.8 Million People.medRxiv : the preprint server for health sciences · 2025Article
- Nationwide, Pragmatic, Direct-to-Patient Primary Aldosteronism Testing Program.Hypertension (Dallas, Tex. : 1979) · 2025Article
- Exploring hypertension-linked diseases: a comprehensive review of innovative drug combinations with enhanced therapeutic potential.Naunyn-Schmiedeberg's archives of pharmacology · 2025Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
Hypertension is the leading risk factor for premature death. The optimal treatment of low-renin hypertension (LRH), present in 30% of hypertensive individuals, is not known. LRH likely reflects a state of excess salt, expanded volume and/or mineralocorticoid receptor (MR) activation. Therefore, targeted treatment with MR antagonists (MRA) may be beneficial. The objective of this systematic review was to assess the efficacy of MRA therapy in LRH. MEDLINE, Embase and Cochrane databases were searched for randomised controlled trials of adults with LRH that compared the efficacy of MRA to placebo or other antihypertensive treatments. Risk of bias was assessed using the Cochrane risk of bias tool. A meta-analysis was performed using a random-effects model to estimate the difference in blood pressure and the certainty of evidence was assessed using the GRADE approach. The protocol is registered on PROSPERO (CRD42022318763). From the 1612 records identified, 17 studies met the inclusion criteria with a total sample size of 1043 participants. Seven studies (n = 345) were assessed as having a high risk of bias. Meta-analysis indicated that MRA reduced systolic blood pressure by -6.8 mmHg (95% confidence interval -9.6 to -4.1) and -4.8 mmHg (95% confidence interval -11.9 to 2.4) compared to angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) and diuretics. The certainty of the evidence was assessed as moderate and very low, respectively. The findings of this systematic review suggest that MRA is effective in lowering blood pressure in LRH and may be better than ACEi/ARB. Translation to clinical practice is limited by the uncertainty of evidence.
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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.