# Aldosteronsynthaseremmers bij hypertensie: meta-analyse van RCT's

*geplaatst 2025-04-01 · Hypertensie · Hypertension (Dallas, Tex. : 1979) · doi 10.1161/HYPERTENSIONAHA.124.23962 · https://hartvaat.nl/2025/04/01/aldosteronsynthaseremmers-bij-hypertensie-meta-analyse-van-rct-s/*

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.

## English: Efficacy and Safety of Aldosterone Synthase Inhibitors for Hypertension: A Meta-Analysis of Randomized Controlled Trials and Systematic Review.

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.

## Abstract (original, from the publication)

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.

Auteurs: Luigi Marzano, Matteo Merlo, Nicola Martinelli, Francesca Pizzolo, Simonetta Friso

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Bron: Hypertension (Dallas, Tex. : 1979), https://doi.org/10.1161/HYPERTENSIONAHA.124.23962. Bijgewerkt 2026-07-03T18:39:15Z. 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.