Page 6 - hypertension_newsletter9

REFLECTIONS
Hypertension
Hypertension Global Newsletter #9 2025

targeted science and clinical investigations are needed to
increase the evidence base and consequently raise the CI in CLINICAL PEARLS FROM THE FACULTY Hypertension
areas where certainty is low, such as cerebrovascular disease
and hypertension in pregnancy.

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TREATMENT

Lorundrostat in participants with uncontrolled hypertension and treatment-

resistant hypertension: The launch-HTN randomized clinical trial.
Saxena M, et al. JAMA. 2025 Jun;334(5):409-418.

Despite the extensive availability of antihypertensive treatments, more than 40% of adults with hypertension do not have adequate
BP control. This issue is particularly severe in patients with treatment-resistant hypertension (TRH), defined as the inability to
reach target BP despite receiving at least three different classes of antihypertensive medications, including a diuretic. Evidence
suggests that dysregulated aldosterone production is implicated in up to 30% of these patients, yet existing aldosterone-targeted
therapies such as mineralocorticoid receptor antagonists (MRAs) are underused due to safety concerns, including hyperkalemia,
acute declines in eGFR, and endocrine side effects (gynecomastia).
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