Post-treatment renin status and cardiovascular, renal, and mortality outcomes in medically treated primary aldosteronism: a systematic review and meta-analysis
Pooled result · Cardiovascular eventsResult — go to the resultPooled hazard ratio 0.43 95% CI 0.23–0.80Authors' conclusion
The association between unsuppressed renin following medical therapy for primary aldosteronism and reduced risk of cardiovascular events and all-cause mortality suggests that renin normalisation might serve as a therapeutic target. Prospective studies are required to formally confirm that medication titration to normalise renin improves clinical outcomes.
Study context
- Population
- Patients with PA on mineralocorticoid receptor antagonists
- Participants
- 6,621 patients24 studies
- Comparison
- Unsuppressed vs suppressed post-treatment renin
- Outcome
- Incidence of cardiovascular events, renal events and all-cause mortality
Methodological detailsrandom-effects models, Quality in Prognostic Studies (QUIPS) risk-of-bias assessment, pre-registered protocol, Risk of bias: none of the studies low risk across all QUIPS domains; many high risk in Domain 5 (confounding)
- Random-effects models
- QUIPS risk-of-bias assessment
- Pre-registered protocol
- Risk of bias: none of the studies low risk across all QUIPS domains; many high risk in Domain 5 (confounding)
Pooled result
Cardiovascular events
Pooled hazard ratio
0.43
95% CI 0.23–0.80
Unsuppressed reninvs Suppressed renin
pooled HR 0.43 (95% CI 0.23–0.80)
As reported in the abstract
Further pooled results
| Outcome | Estimate | |
|---|---|---|
| Renal outcomes | pooled HR 0.95 (95% CI 0.51–1.77) | |
| All-cause mortality1 study, 201 patients; low certainty | HR 0.29 (95% CI 0.09–0.98) | |
| Cardiovascular events, subgroup ≥5 years follow-up · 5 or more years of follow-upI2=0%, 3 studies, 754 patients; moderate certainty | pooled HR 0.33 (95% CI 0.19–0.57) | |
| 0.050.21520Ratio (log scale) |
- Renal outcomes: 2 studies, I2=0%; very low certainty; no significant association
Original publication
Post-treatment renin status and cardiovascular, renal, and mortality outcomes in medically treated primary aldosteronism: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. Published 24 October 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →