New hope for Hard-to-Control blood pressure: finerenone shows promise

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age:18-75 years old. 2. History of hypertension, with a sitting SBP ≥140 and \<180 mmHg, and a sitting DBP ≥90 and \<120 mmHg during the last two evaluations within the observation period. 3. Patients with PA who are eligible for drug treatment. 4. Diagnostic criteria for primary aldosteronism: (1) Hypertension or use of antihypertensive medications, with or without hypokalemia; (2) Screening test: Baseline plasma aldosterone to renin ratio (ARR) \>30 (ng/dl)/(ng/ml/h) or ARR \>2.4 (ng/dl)/(mU/L), with plasma aldosterone \>15 ng/dl and plasma renin activity \<1.0 ng/ml/h; (3) At least one confirmed test is positive: ① After a captopril test, plasma aldosterone decreases by \<30% or plasma aldosterone is ≥11 ng/dl, with suppressed renin activity; ② Sitting saline infusion test results in a plasma aldosterone ≥10 ng/dl. 5. eGFR ≥60 ml/ (min\*1.73m2). 6. Signed informed consent form. Exclusion Criteria: 1. Other secondary hypertension (such as renal vascular hypertension, Cushing's syndrome, subclinical Cushing's syndrome, and pheochromocytoma) or hypertensive crisis. 2. Orthostatic hypotension. 3. Heart failure, acute myocardial infarction, stroke, transient ischemic attack, or other acute cardiovascular events within the past 6 months. 4. History of adrenal surgery within the past 6 months. 5. History of carotid artery surgery within the past 6 months. 6. History of arterial vascular reconstruction surgery within the past 6 months. 7. Hospitalization within the past year due to severe hyperkalemia, with serum potassium levels \<2.5 or ≥5.0 mmol/L. 8. Abnormal liver function: alanine aminotransferase (ALT) and aspartate aminotransferase (AST) \> 2.5× upper limit of normal (ULN), total bilirubin (TBIL) \> 1.5× ULN. 9. Use of spironolactone, hydralazine, or minoxidil within 30 days prior to enrollment. 10. Concurrent use of potent CYP3A4 inhibitors or inducers for treatment. 11. Known or suspected tumors; other autoimmune diseases, uncontrolled infectious diseases, severe respiratory, blood, and neurological diseases. 12. Pregnancy or planning pregnancy within 3 months before or after treatment, and breastfeeding women. 13. Mental illness, alcohol or drug abuse, inability to cooperate with treatment. 14. Patients with pacemakers. 15. Participation in other clinical trials.