Blood Pressure-Lowering Effects of Aldosterone Synthase Inhibitors in Uncontrolled or Resistant Hypertension: A Systematic Review and Meta-Analysis of Recent Randomized Controlled Trials

Background

The overproduction of aldosterone is an important cause of uncontrolled or resistant hypertension. Conversely, aldosterone synthase inhibitors including baxdrostat and lorundrostat have an upstream effect blocking aldosterone synthesis. The overproduction of aldosterone causes many drug resistant hypertensive diseases. Agents that act at the Mineralocorticoid Receptor (MR), i.e., MR Antagonists (MRAs) such as spironolactone and eplerenone block signalling downstream of aldosterone, thereby inducing BP lowering effects. Conversely, aldosterone synthase inhibitors inculding baxdrostat and lorundrostat have an upstream effect at the aldosterone level, thereby specifically reducing the production of aldosterone in the adrenal cortex.

Objective