Effect of fourth-line antihypertensive therapy on clinic systolic blood pressure in resistant hypertension: a systematic review and meta-analysis.
Taha Alam, Muhammad Saad, Taha Ibrahim et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and safety of fourth-line antihypertensive therapies in reducing clinic systolic blood pressure (SBP) in 3,931 adults with resistant hypertension. The study found that lorundrostat and baxdrostat 2 mg significantly reduced SBP by -11.70 mmHg and -10.10 mmHg, respectively, compared to placebo, without increasing serious adverse events.
Key findings
- Lorundrostat reduced SBP by -11.70 mmHg compared to placebo.
- Baxdrostat 2 mg achieved a SBP reduction of -10.10 mmHg.
- Spironolactone produced a similar reduction in SBP of -7.95 mmHg.
- Aprocitentan 25 mg was associated with a higher rate of adverse events (RR 1.89).
Why it matters
Understanding the effectiveness of fourth-line antihypertensive therapies is crucial for managing resistant hypertension, which poses significant cardiovascular risks. This evidence can guide clinicians in selecting appropriate treatment options for patients who do not respond to standard therapies.