Role of Mineral Corticosteroid Receptor Antagonist (MRA) as a Therapeutic Approach for Hypertension Management

Introduction: Hypertension remains a pervasive global health challenge. Emerging research highlights the potential of Mineral Corticosteroid Receptor Antagonists (MRAs) in addressing hypertension’s complexities. This study aims to elucidate the potential of MRAs, offering new insights in comprehensive hypertension management strategies. Methods: A systemic search was conducted on electronic databases, including PubMed and Google Scholar. Keywords related to MRA and hypertension were used to obtain data from the database. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) mean change, ambulatory 24 hour SBP and DBP mean change, as well as treatment-related adverse event (TRAE) were analysed using Review Manager (Version 5.4, cochrane collaboration, UK). Results: 7 low risk bias studies with 2670 patients were obtained and included in this study. Significant reduction is seen in SBP and DBP [-6.36/–2.63 mmHg CI 95% = -9.41 to -3.32 / -4.5 to -0.7 mmHg, p < 0.0001] mean change from baseline and 24 hr ambulatory [-5.57/-3.74 mmHg CI 95% = -15.73 to -4.59 / -7.67 to -0.2 mmHg, p < 0.0001] favouring in MRA therapy. However, TRAE is markedly increased in MRA therapy [OR 2.06, CI 95% =0.53 - 7.99, p = <0.0001]. Conclusion: MRAs are effective as a therapeutic approach for treating patients with hypertension. However, treatment should also focus on preventing TRAE to increase the efficacy of its treatment, and increasing patients’ quality of life. This finding should be used with caution, as results are limited to current studies, and further research should be done to confirm its effectiveness.