Key result
RNA-based therapy demonstrated the most favorable profile among RAAS-targeted agents for hypertension, showing a trend toward improved blood pressure control (OR 0.51) compared to control.
Why the study?
Do ARNI, NMRA, brain RAS therapy, and RNA-based therapy improve blood pressure control and safety in patients with high blood pressure?
Meta-Analysis
Do ARNI, NMRA, brain RAS therapy, and RNA-based therapy improve blood pressure control and safety in patients with high blood pressure?
RNA-based therapy appears to outperform ARNI, NMRA, and brain RAS therapies in terms of both blood pressure reduction efficacy and safety profile.
May guide RAAS-agent selection in hypertension; extends comparative efficacy data from network meta-analysis.
Introduction: This study reviews the efficacy and safety of angiotensin receptor neprilysin inhibitor (ARNI), nonsteroidal mineralocorticoid receptor antagonists (NMRA), brain rennin-angiotensin system (RAS) therapy, and ribonucleic acid (RNA)-based therapy with evaluating systolic blood pressure and diastolic blood pressure control as well safety by counting adverse events. Methods: Risk of Bias 2.0 were used for quality appraisal and RevMan 5.4 was applied for the meta-analysis. Results: From five databases, 20 articles were selected for review. Six high-risk and fourteen low-risk studies. ARNI and RNA-based therapies improved BP regulation, while NMRA and brain RAS were less effective in managing high blood pressure. In terms of safety, NMRA and RNA-based therapies had fewer adverse events, whereas ARNI and brain RAS had more AEs compared to their control groups. Conclusion: RNA-based therapy outperforms the four antihypertensive drugs studied in terms of efficacy and safety, underscoring its potential as the leading option and justifying further research.
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Rampengan et al. (2025) conducted a meta-analysis in Hypertension. RNA-based therapy vs. Control was evaluated on Blood pressure control (OR 0.51, 95% CI 0.21-1.25, p=0.14). RNA-based therapy demonstrated the most favorable profile among RAAS-targeted agents for hypertension, showing a trend toward improved blood pressure control (OR 0.51) compared to control.
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