Blood pressure response to mineralocorticoid receptor antagonists or aldosterone synthase inhibitors according to baseline renin levels.

Plasma renin is a surrogate marker of sodium retention in hypertension, and its levels are suppressed in conditions of heightened aldosterone production. We performed a random-effects meta-analysis of randomized clinical trials focusing on the impact of mineralocorticoid receptor antagonists (MRA) and aldosterone synthase inhibitors (ASi) on blood pressure according to baseline renin levels. We included four randomized clinical trials, and we found that the response to MRA or ASi was independent of baseline plasma renin levels.