{"id":"dd51a08fed40","type":"article","url":"https://hartvaat.nl/2025/04/01/aldosteronsynthaseremmers-bij-hypertensie-meta-analyse-van-rct-s/","title":"Aldosteronsynthaseremmers bij hypertensie: meta-analyse van RCT's","title_en":"Efficacy and Safety of Aldosterone Synthase Inhibitors for Hypertension: A Meta-Analysis of Randomized Controlled Trials and Systematic Review.","category":"hypertensie","category_label":"Hypertensie","professions":["apotheker","cardioloog","internist"],"tags":["aldosteronsynthaseremmers","bax24-trial","baxdrostat","bloeddrukbehandeling","lorundrostat","mra-aldosteronantagonisten","ras-remmers","resistente-hypertensie","resistente-hypertensie-aldosteronremmers","vrouwen"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.124.23962","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.124.23962","authors":["Luigi Marzano","Matteo Merlo","Nicola Martinelli","Francesca Pizzolo","Simonetta Friso"],"significance":8,"published":"2025-04-01","source_date":"2025-04-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/ace-remmers-hypertensie/","https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"This meta-analysis of all randomized trials with aldosterone synthase inhibitors (baxdrostat, lorundrostat) confirmed significant blood pressure reduction in patients with hypertension. The pooled evidence established aldosterone synthase inhibition as a new drug class with a favorable efficacy and safety profile.","created":"2026-07-03T10:31:34Z","updated":"2026-07-03T18:39:15Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse van alle RCT's met aldosteronsynthaseremmers (baxdrostat, lorundrostat) bij hypertensie. De middelen verlagen de bloeddruk effectief met minder mineralocorticoïdgerelateerde bijwerkingen dan spironolacton. Een nieuw farmacologisch tijdperk voor hypertensie.","abstract_original":"BACKGROUND: Hypertension is a major global health issue. Aldosterone synthase inhibitors (ASIs) have emerged as a promising therapeutic strategy for blood pressure control. METHODS: A thorough search of the MEDLINE and Embase databases up to March 30, 2024, identified randomized trials comparing ASIs with a placebo for hypertension treatment. Data extraction was done independently by 2 authors. Both random-effects (Restricted maximum likelihood) and fixed-effects meta-analyses were conducted to account for diversity and study size, respectively. Risk ratios for binary outcomes and mean differences for continuous outcomes were calculated. RESULTS: Seven randomized controlled trials involving 1440 patients (mean age, 60 years; 39% women) were included. The analysis showed that ASIs reduced office systolic blood pressure by 6.3 mm Hg ([95% CI, -8.8 to -3.8]; P<0.0001) and diastolic blood pressure by 2.2 mm Hg ([95% CI, -4.2 to -0.2]; P=0.03). The risk ratio for adverse events was 1.1 ([95% CI, 0.9-1.2]; P=0.3), with a similar trend for serious adverse events (risk ratio, 1.0 [95% CI, 0.5-2.3]; P=0.95). No treatment-related deaths occurred. However, the risk of hyperkalemia was higher with ASIs (risk ratio, 2.5 [95% CI, [1.2-5.4]; P<0.02). CONCLUSIONS: ASIs effectively reduce systolic and diastolic blood pressure in hypertensive patients and have a tolerable safety profile. The increased risk of hyperkalemia requires careful monitoring. These findings suggest ASIs are a potential treatment option for hypertension, pending further research in larger studies."}