SynthesisDrugs2025
Aldosterone Synthase Inhibitors for Resistant Hypertension: Pharmacological Insights - A Systematic Review.
Synthesis in Drugs, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- When Methods Matter: An Umbrella Review of Lorundrostat and the Impact of Analytical Decisions on Reported Blood Pressure and Safety Outcomes.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2026Pooled it
- Efficacy and Safety of Baxdrostat for Hypertension: A Systematic Review and Meta-Analysis of Three Phase 2/3 Randomized Controlled Trials.Clinical cardiology · 2026Pooled it
- Pooled it
- Targeting the aldosterone-mineralocorticoid receptor pathway in cardiovascular-kidney-metabolic syndrome.Nature reviews. Nephrology · 2026Review
- Comparative Efficacy of Aldosterone-Related Sodium-Retention Pathway Therapies for Resistant Hypertension: A Drug-Level Network Meta-Analysis of Randomized Controlled Trials.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Endocrine society 2025 diagnostic criteria increase primary aldosteronism detection in hypertensive patients: a comparative study with 2016 guidelines.International journal of cardiology. Cardiovascular risk and prevention · 2026Article
- Aldosterone synthesis inhibitors in resistant hypertension: the BaxHTN trial.European heart journal supplements : journal of the European Society of Cardiology · 2026Article
- Review
- European Hypertension Guidelines: Similarities and What the Practicing Physician Should Keep in Mind.Journal of clinical medicine · 2026Review
- Highlights of the 2026 Korean Society of Hypertension guidelines for the management of hypertension: what's new and what has changed.Clinical hypertension · 2026Review
- Efficacy and safety of selective aldosterone synthase inhibitors in uncontrolled hypertension: a systematic review and meta-analysis of randomized controlled trials.Clinical hypertension · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundResistant hypertension (RHT) is a challenging clinical condition characterized by persistently elevated blood pressure despite adherence to lifestyle modifications and the use of at least three antihypertensive agents, including a high-dose diuretic. RHT is a heterogeneous condition, influenced by multiple pathophysiological mechanisms such as sodium retention, sympathetic overactivity, and vascular dysfunction. Among these, hyperaldosteronism plays a pivotal role in a subset of patients.
methodsThis systematic review examines in depth the pharmacokinetic properties of aldosterone synthase inhibitors (ASIs), with a focus on their therapeutic potential in patients with RHT. A comprehensive literature search was conducted to identify clinical trials and pharmacological studies investigating ASIs, including baxdrostat, dexfadrostat, lorundrostat, LY3045697, and osilodrostat (LCI699).
resultsASIs have shown compelling efficacy in lowering both office-based and 24-h ambulatory blood pressure, particularly in patients with elevated aldosterone levels. These findings underscore the critical role of aldosterone-mediated mechanisms in the pathophysiology of RHT. The inhibitors differ substantially in their metabolic pathways, selectivity profiles, and pharmacokinetic characteristics.
conclusionsEmerging data support the potential of ASIs as a therapeutic option for RHT, particularly when treatment is individualized based on renal function, dietary sodium intake, and comorbidities. Personalized treatment strategies may enhance efficacy, improve tolerability, and support durable blood pressure control in this difficult-to-treat population. REGISTRATION: PROSPERO identifier number CRD42024522918 [Graphical abstract available].
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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.