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The primary endpoint, change in morning home systolic\/diastolic blood pressure (SBP\/DBP) from baseline to end of treatment was similar between the two groups (intergroup difference in least squares mean change [95% confidence interval]: \u22121.3 [\u22123.8, 1.3]\/\u22120.2 [\u22121.6, 1.3] mmHg for ARB; \u22122.7 [\u22124.2, \u22121.2]\/\u22120.8 [\u22121.7, 0.1] mmHg for CCB). The respective incidences of serum potassium levels &lt;3.5\u2009mEq\/L and \u22655.5\u2009mEq\/L in the ARB subgroup were 3.4% and 4.2% for esaxerenone and 7.9% and 0% for trichlormethiazide; in the CCB subgroup, they were 2.8% and 0.6% for esaxerenone and 13.9% and 1.2% for trichlormethiazide, respectively. The incidence of uric acid level \u22657.0\u2009mg\/dL was numerically higher in the trichlormethiazide group than the esaxerenone group in both the ARB and CCB subgroups. The non-inferiority of esaxerenone to trichlormethiazide in lowering morning home BP was demonstrated regardless of whether the basal antihypertensive agent was an ARB or CCB. Esaxerenone with a CCB showed superiority to trichlormethiazide in lowering SBP, without any new safety concerns. Serum potassium levels tended to be higher when esaxerenone was combined with an ARB than with a CCB, but this can be mitigated if administered according to the package insert.<\/jats:p>","DOI":"10.1038\/s41440-024-01887-1","type":"journal-article","created":{"date-parts":[[2024,10,12]],"date-time":"2024-10-12T01:01:31Z","timestamp":1728694891000},"page":"506-518","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Home blood pressure-lowering effect of esaxerenone versus trichlormethiazide for uncontrolled hypertension: a predefined subanalysis of the EXCITE-HT randomized controlled trial by basal calcium channel blocker versus angiotensin receptor blocker"],"prefix":"10.1038","volume":"48","author":[{"given":"Kazuomi","family":"Kario","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Ohbayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Hashimoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Itabashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsutoshi","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Uchiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunio","family":"Hirano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahide","family":"Miyamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Nagashima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Ebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuguru","family":"Hatta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiki","family":"Fukui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Shimosawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Katsuya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Taguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumi","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuru","family":"Ohishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the EXCITE-HT investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,12]]},"reference":[{"key":"1887_CR1","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1016\/j.jacc.2016.01.037","volume":"67","author":"K Kario","year":"2016","unstructured":"Kario K, Saito I, Kushiro T, Teramukai S, Tomono Y, Okuda Y, et al. 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K Kario received research grants from Otsuka Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., MSD K.K., Sumitomo Pharma Co., Ltd., and Nippon Boehringer Ingelheim Co., Ltd.; consulting fees from Sanwa Kagaku Kenkyusho Co., Ltd.; honoraria from Otsuka Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., and Novartis Pharma K.K., Viatris Inc.; and is an advisory board member of Daiichi Sankyo Co., Ltd. and Novartis Pharma K.K. T Shimosawa received research funding from Takenaka Co., Ltd., FUJIFILM Corp., Nippon Boehringer Ingelheim Co., Ltd., Teijin Pharma Ltd., Sumitomo Pharma Co., Ltd., Eli Lilly Japan K.K., and Otsuka Pharmaceutical Co., Ltd.; consultant fees from Sekisui Medical Co., Ltd. and EP Mediate Co., Ltd.; honoraria from Novartis Pharma K.K., Taisho Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Sanofi K.K., Mochida Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Aeon Co., Ltd., FUJIFILM Corp., Otsuka Pharmaceutical Co., Ltd., Astellas Pharma Inc., Mitsubishi Tanabe Pharma Corp., Elsevier Japan K.K., Abbott Japan LLC., and Eiken Chemical Co., Ltd.; is a board member of Otsuka Medical Devices Co., Ltd. and Daiichi Sankyo Co., Ltd.; and is the chair of CVEM2023 and deputy director and educational seminars chair of the Japanese Society of Medical Use of Functional Food, and the steering committee of Angiotensin Gordon Research Conference. T Katsuya received honoraria from Novartis Pharma K.K., Takeda Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Mochida Pharmaceutical Co., Ltd., AstraZeneca K.K., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., and Moderna, Inc.; payment for expert testimony from Takeda Pharmaceutical Co., Ltd. and Novartis Pharma K.K.; and support for travel expenses from Takeda Pharmaceutical Co., Ltd., Novartis Pharma K.K., and AstraZeneca K.K. T Taguchi and A Tanabe are employees of Daiichi Sankyo Co., Ltd.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}