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Systolic Blood Pressure and Pulse Pressure in Heart Failure: Pooled Participant-Level Analysis of 4 Trials.
J Am Coll Cardiol
November 2024
Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. Electronic address:
Background: Hypertension is common in patients with heart failure with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF), and current guidelines recommend treating systolic blood pressure (SBP) to a target <130 mm Hg. However, data supporting treatment to this target are limited. Additionally, pulse pressure (PP), a marker of aortic stiffness, has been associated with increased risk of cardiovascular events, but its prognostic impact in HFpEF has not been extensively studied.
View Article and Find Full Text PDFEplerenone, a mineralocorticoid receptor inhibitor, reduces cirrhosis associated changes of hepatocyte glucose and lipid metabolism.
Cell Commun Signal
December 2024
Julius-Bernstein-Institute of Physiology, Martin Luther University Halle-Wittenberg, Magdeburger Strasse 6, 06112, Halle (Saale), Germany.
Background: Recent studies suggest a contribution of intrahepatic mineralocorticoid receptor (MR) activation to the development of cirrhosis. As MR blockade abrogates the development of cirrhosis and hypoxia, common during the development of cirrhosis, can activate MR in hepatocytes. But, the impact of non-physiological hepatic MR activation is unknown.
View Article and Find Full Text PDFFinerenone, Obesity, and Heart Failure With Mildly Reduced/Preserved Ejection Fraction: Prespecified Analysis of FINEARTS-HF.
J Am Coll Cardiol
December 2024
British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom. Electronic address:
Background: Obesity is associated with excessive adipocyte-derived aldosterone secretion, independent of the classical renin-angiotensin-aldosterone cascade, and mineralocorticoid receptor antagonists may be more effective in patients with heart failure (HF) and obesity.
Objectives: This study sought to examine the effects of the nonsteroidal mineralocorticoid receptor antagonist finerenone compared with placebo, according to body mass index (BMI) in FINEARTS-HF (FINerenone trial to investigate Efficacy and sAfety superioR to placebo in paTientS with Heart Failure).
Methods: A total of 6,001 patients with HF with NYHA functional class II, III, and IV, a left ventricular ejection fraction of ≥40%, evidence of structural heart disease, and elevated natriuretic peptide levels were randomized to finerenone or placebo.
Primary aldosteronism during pregnancy and eplerenone use - a case report.
Obstet Med
December 2024
Department of Obstetrics and Gynaecology, JIPMER, Puducherry, India.
Article Synopsis
- - Primary aldosteronism is a notable contributor to secondary hypertension, but instances of pregnancy in such patients are uncommon.
- - Eplerenone, an aldosterone antagonist, is utilized to manage primary aldosteronism, and this case details a young woman's successful pregnancy while being treated with it since before conception.
- - Only five case reports exist in the literature regarding the use of eplerenone during pregnancy, highlighting the uniqueness of this case.
Association between mineralocorticoid receptor antagonists and kidney harm: A systematic review and meta-analysis of randomized controlled trials.
Pharmacotherapy
November 2024
Department of Pharmacy, Zikei Hospital/Zikei Institute of Psychiatry, Okayama, Japan.
Article Synopsis
- A systematic review and meta-analysis were conducted to determine the impact of mineralocorticoid receptor antagonists (MRAs) on the risk of acute kidney injury (AKI), sourcing data from various medical databases.
- The analysis included 33 randomized controlled trials (RCTs) that involved patients with heart or kidney disease, showing no significant increase in AKI risk when using MRAs (RR 1.13), but did find an increased risk of kidney injury overall (RR 1.52).
- Specific MRAs like canrenone and spironolactone were linked to a higher risk of kidney injury, while eplerenone and finerenone did not appear to increase this risk, suggesting that the choice
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