We evaluated the efficacy and safety of baxdrostat in adults with uncontrolled or resistant hypertension. We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL from inception to January 2026. We included randomized controlled trials that involved hypertension patients with resistance type and compared baxdrostat versus placebo. The primary outcomes were the changes in mean seated systolic blood pressure and diastolic blood pressure. Secondary outcomes included changes in estimated glomerular filtration rate (eGFR), serum potassium, and serum aldosterone. Three randomized controlled trials were finally included, comprising 1264 patients were followed for 12-24 weeks. Compared with placebo, baxdrostat reduced seated systolic blood pressure by 8.62 mm Hg [mean difference (MD) = -8.62, 95% confidence interval (CI), -10.55 to -6.70, P < 0.001] and seated diastolic blood pressure by 3.55 mm Hg (MD = -3.55, 95% CI, -4.81 to -2.28, P < 0.001). Baxdrostat lowered serum aldosterone by 4.03 ng/dL, reduced eGFR by 5.49 mL/min/1.73 m2, and increased serum potassium by 0.39 mmol/L. However, baxdrostat was associated with higher adverse events compared with the placebo. Baxdrostat lowers blood pressure and aldosterone levels in uncontrolled and resistant hypertension but increases potassium and modestly reduces eGFR, supporting careful laboratory monitoring and longer trials to evaluate long-term clinical outcomes.
A. Gadelmawla, A. W. Hageen, R. Rateb et al.· Cardiology in Review· 0 citations
Aortic stenosis (AS) is the most common degenerative valvular disease in elderly patients and is linked to high morbidity and mortality. Accurate diagnosis and risk stratification are critical for effective management. Transthoracic echocardiography is the standard diagnostic tool, but its reliance on flow-dependent parameters can lead to inconsistent grading, especially in low-flow, low-gradient, or normal-flow, low-gradient AS. Advanced echocardiographic methods, such as 3D imaging, stress echocardiography, and Doppler indices, such as the mean gradient-to-effective orifice area ratio, improve the evaluation of AS severity and assist in clinical decision-making. Computed tomography provides a flow-independent evaluation of AS. It uses noncontrast calcium scoring with sex-specific thresholds, along with contrast-enhanced angiography, for detailed anatomical assessment. These modalities are essential for procedural planning, particularly for transcatheter aortic valve replacement. Cardiac magnetic resonance (CMR) provides additional prognostic information. It quantifies myocardial remodeling and fibrosis, which are associated with outcomes and recovery potential. Emerging technologies are expanding diagnostic capabilities in AS. Examples include 18F-sodium fluoride positron emission tomography for detecting microcalcification, artificial intelligence-based ECG and echocardiography for early diagnosis, and 4D flow CMR. Integration of echocardiography, computed tomography, CMR, and emerging positron emission tomography and artificial intelligence-based approaches can help address diagnostic uncertainty. This integration helps refine AS subtype classification and inform individualized intervention strategies.
H. Itani, M. Moumneh, A. Zayed et al.· Cardiology in Review· 0 citations
