{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T16:39:11Z","timestamp":1782837551674,"version":"3.54.5"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"Supplement_5","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Inhibitors of the renin\u2013angiotensin\u2013aldosterone system remain foundational therapies for arterial hypertension across major international guidelines. Their effectiveness, however, may be partially attenuated by the phenomenon of aldosterone escape, characterized by chronic elevation of adrenal aldosterone due to activation of alternative enzymatic pathways. Mineralocorticoid receptor antagonists are recommended as first-line therapy for resistant hypertension, yet their clinical utility is limited by poor adherence and high discontinuation rates, driven largely by hyperkalaemia and sex hormone\u2013related adverse effects such as gynaecomastia, impotence, and menstrual irregularities. Recent pharmacologic research has focused on alternative strategies for suppressing aldosterone activity, particularly through the development of selective aldosterone synthase inhibitors (ASIs). This approach has led to the emergence of highly selective agents such as baxdrostat and lorundrostat. Clinical studies have demonstrated meaningful reductions in blood pressure among patients with resistant or uncontrolled hypertension, with favourable tolerability and without clinically significant adverse events. Further studies are required to determine the impact of ASIs on hypertensive-mediated organ damage, major cardiovascular events, nephrovascular outcomes, and long-term safety.<\/jats:p>","DOI":"10.1093\/eurheartjsupp\/suag049","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T12:24:47Z","timestamp":1771849487000},"page":"v177-v180","source":"Crossref","is-referenced-by-count":1,"title":["Aldosterone synthesis inhibitors in resistant hypertension: the BaxHTN trial"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4845-117X","authenticated-orcid":false,"given":"Giovanna","family":"Gallo","sequence":"first","affiliation":[{"name":"Clinical and Molecular Medicine Department, Sapienza University of Rome , Via di Grottarossa 1035-1039, 00189 Rome ,","place":["Italy"]},{"name":"Cardiology Unit, Sant\u2019Andrea University Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2624-9213","authenticated-orcid":false,"given":"Maurizio","family":"Volterrani","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele , Via della Pisana 235, 00163 Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0635-4921","authenticated-orcid":false,"given":"Giuliano","family":"Tocci","sequence":"additional","affiliation":[{"name":"Clinical and Molecular Medicine Department, Sapienza University of Rome , Via di Grottarossa 1035-1039, 00189 Rome ,","place":["Italy"]},{"name":"Cardiology Unit, Sant\u2019Andrea University Hospital , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9642-8380","authenticated-orcid":false,"given":"Massimo","family":"Volpe","sequence":"additional","affiliation":[{"name":"Clinical and Molecular Medicine Department, Sapienza University of Rome , Via di Grottarossa 1035-1039, 00189 Rome ,","place":["Italy"]},{"name":"IRCCS San Raffaele , Via della Pisana 235, 00163 Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"2026050607112813500_suag049-B1","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1097\/HJH.0000000000003480","article-title":"2023 ESH guidelines for the management of arterial hypertension the task force for the management of arterial hypertension of the European Society of Hypertension: endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA)","volume":"41","author":"Mancia","year":"2023","journal-title":"J Hypertens"},{"key":"2026050607112813500_suag049-B2","doi-asserted-by":"crossref","first-page":"3912","DOI":"10.1093\/eurheartj\/ehae178","article-title":"2024 ESC guidelines for the management of elevated blood pressure and hypertension","volume":"45","author":"McEvoy","year":"2024","journal-title":"Eur Heart J"},{"key":"2026050607112813500_suag049-B3","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1007\/s40292-025-00748-3","article-title":"Hypertension international guidelines: three of a kind?","volume":"32","author":"Virdis","year":"2025","journal-title":"High Blood Press Cardiovasc Prev"},{"key":"2026050607112813500_suag049-B4","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1161\/HYPERTENSIONAHA.122.17964","article-title":"Aldosterone as a mediator of cardiovascular damage","volume":"79","author":"Buffolo","year":"2022","journal-title":"Hypertension"},{"key":"2026050607112813500_suag049-B5","doi-asserted-by":"crossref","first-page":"2059","DOI":"10.1016\/S0140-6736(15)00257-3","article-title":"Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension(PATHWAY-2): a randomised, double-blind, crossover trial","volume":"386","author":"Williams","year":"2015","journal-title":"Lancet"},{"key":"2026050607112813500_suag049-B6","doi-asserted-by":"crossref","first-page":"e002022","DOI":"10.1136\/openhrt-2022-002022","article-title":"Motives, frequency, predictors and outcomes of MRA discontinuation in a real-world heart failure population","volume":"9","author":"Jonsson Holmdahl","year":"2022","journal-title":"Open Heart"},{"key":"2026050607112813500_suag049-B7","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1007\/s40265-025-02229-2","article-title":"Aldosterone synthase inhibitors for resistant hypertension: pharmacological insights. 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