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January 19, 2021HypertensionOpen Access

Effect of Mineralocorticoid Receptor Blockade on Arterial Stiffness and Endothelial Function

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Why the study?

Although pharmacological therapy benefits arterial stiffness and endothelial dysfunction, few overall quantitative evaluations of MRAs exist.

Does mineralocorticoid receptor antagonist therapy improve arterial stiffness and endothelial function compared to control?

Population

Patients across randomized trials evaluating MRA effects

Comparison

MRA treatment vs control

Design

Random-effects meta-analysis of randomized trials

Key result

Mineralocorticoid receptor antagonists significantly reduced pulse wave velocity compared with control (MD -0.75 m/s; 95% CI -1.12 to -0.39; P<0.00001).

Authors

ASAtsushi SakimaHAHisatomi ArimaTMTetsutaro Matayoshi

Discussion

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Overview

Supports MRA use targeting arterial stiffness in hypertension; extends meta-analytic evidence on vascular surrogates beyond BP reduction.

Study Design

Type

Meta-Analysis (n=515)

Structured PICO

Does mineralocorticoid receptor antagonist therapy improve arterial stiffness and endothelial function compared to control?

P
Population
Up to 570 patients pooled from 11 randomized trials evaluating the effects of mineralocorticoid receptor antagonists on arterial stiffness and endothelial function.
I
Intervention
Mineralocorticoid receptor antagonists (MRAs) as a class
C
Comparator
Control
O
Outcome
Mean difference (MD) of pulse wave velocity (PWV)surrogate

Main Result

Effect estimate: MD -0.75 m/s (95% CI -1.12 to -0.39)

p-value: p=<0.00001

MRA therapy significantly improves surrogate markers of arterial stiffness and endothelial function, independent of its blood pressure-lowering effects.

Cite This Study

Sakima et al. (2021) conducted a meta-analysis in Arterial stiffness and endothelial dysfunction (n=515). Mineralocorticoid receptor antagonists (MRAs) vs. Control was evaluated on Mean difference of pulse wave velocity (PWV) (MD -0.75 m/s, 95% CI -1.12 to -0.39, p=<0.00001). Mineralocorticoid receptor antagonists significantly reduced pulse wave velocity compared with control (MD -0.75 m/s; 95% CI -1.12 to -0.39; P<0.00001).

synapsesocial.com/papers/6a158d49814bf8ec9a4ec134https://doi.org/10.1161/hypertensionaha.120.16397
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