Browsing by Author "Anand Vaidya"

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Real-world outcomes of Finerenone in Primary Aldosteronism
    (2025) Uslar, Thomas; Sanfuentes, Benjamín; Muñoz, Iván; Anand Vaidya; Baudrand Biggs, René
    Primary aldosteronism (PA) treatment with mineralocorticoid receptor antagonists (MRAs) is effective but limited by side-effects and low potency of currently available options. Finerenone, a novel MRA, has emerged as a promising alternative but data in PA are lacking. This report presents a real-world study wherein PA patients on eplerenone were forced to switch to finerenone therapy during a national shortage. During treatment with finerenone, blood pressure and antihypertensive dose remained unchanged, but the proportion of patients with normal blood pressure and complete biochemical response was decreased (P = .004 and P = .008, respectively). The latter was determined by a reduction in direct renin concentration, a biomarker previously associated with increased cardiovascular risk in PA. Although these results could be explained by finerenone's unique pharmacokinetics and mechanism of action, further studies are needed to evaluate longitudinal outcomes associated with these findings and determine its effectiveness in PA treatment.
  • No Thumbnail Available
    Item
    The Spectrum of Subclinical Primary Aldosteronism and Incident Hypertension
    (2017) Jenifer M. Brown; Cassianne Robinson-Cohen; Miguel Angel Luque-Fernandez; Matthew A. Allison; Rene Baudrand; Joachim H. Ix; Bryan Kestenbaum; Ian H. de Boer; Anand Vaidya
    Background: Primary aldosteronism is recognized as a severe form of renin-independent aldosteronism that results in excessive mineralocorticoid receptor (MR) activation. Objective: To investigate whether a spectrum of subclinical renin-independent aldosteronism that increases risk for hypertension exists among normotensive persons. Design: Cohort study. Setting: National community-based study. Participants: 850 untreated normotensive participants in MESA (Multi-Ethnic Study of Atherosclerosis) with measurements of serum aldosterone and plasma renin activity (PRA). Measurements: Longitudinal analyses investigated whether aldosterone concentrations, in the context of physiologic PRA phenotypes (suppressed, ≤0.50 μg/L per hour; indeterminate, 0.51 to 0.99 μg/L per hour; unsuppressed, ≥1.0 μg/L per hour), were associated with incident hypertension (defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or initiation of antihypertensive medications). Cross-sectional analyses investigated associations between aldosterone and MR activity, assessed via serum potassium and urinary fractional excretion of potassium.