Breakthrough Mineralocorticoid Receptor Agonists in Cardiovascular Care
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20m 27sPart 1 | Session 5 Panel Discussion and Audience Q&A
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3m 41sPart 1 | Session 1 Introduction and Landscape Overview by Dr Vijay Chopra
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11m 13s
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11m 14s
In this forward-looking presentation, Prof John McMurray explores the emerging role of aldosterone synthase inhibitors (ASIs) as a potential next generation of anti-aldosterone therapy. Building on the limitations of traditional MRAs, he explains why targeting aldosterone production itself may offer theoretical advantages, including avoiding counter-regulatory rises in aldosterone, reducing off-target hormonal effects, and potentially blocking both genomic and non-genomic pathways implicated in fibrosis, oxidative stress, and cardiac remodelling.
Prof McMurray reviews the current human evidence for ASIs, focusing on recent hypertension trials where agents such as baxdrostat have produced substantial and sustained reductions in systolic blood pressure, even in patients with resistant hypertension. He also discusses safety findings, noting that while hyperkalaemia can occur, serious events remain uncommon.
Looking ahead, the presentation outlines multiple ongoing cardiovascular trials evaluating ASIs as treatments for heart failure with reduced ejection fraction, heart failure with preserved ejection fraction, and—most intriguingly—as heart failure prevention therapies in high-risk populations with type 2 diabetes, hypertension, and established cardiovascular disease. These large-scale studies, conducted alongside SGLT2 inhibitors and background guideline-directed therapy, aim to determine whether ASIs can reduce heart failure events or even prevent heart failure from developing.
Prof McMurray also highlights similar ASI trials underway in chronic kidney disease, reinforcing the broad potential of this therapeutic class across the cardiorenal continuum.
This session offers an engaging preview of what could become a major future pillar of cardiovascular and renal care, pending results from several landmark trials currently in progress.
In this expert-led webinar moderated by Dr Vijay Chopra, leading clinicians review current and emerging strategies in aldosterone modulation, hyperkalaemia management, and cardiorenal therapeutics.
Dr Javed Butler opens with a practical overview of aldosterone’s central role in heart failure and CKD, emphasising the importance of achieving guideline-directed RAAS inhibitor and MRA dosing. He outlines real-world barriers posed by hyperkalaemia and provides clear strategies to maintain life-saving therapy safely, including the use of modern potassium binders.
Dr Dinesh Khullar presents the clinical evidence for finerenone, a non-steroidal MRA with improved selectivity and a lower risk of hyperkalaemia. He summarises key findings from FIDELITY, CONFIDENCE, and FINEARTS-HF, demonstrating meaningful reductions in CKD progression, heart failure events, albuminuria, and cardiovascular risk, particularly when combined with SGLT2 inhibitors.
Prof John McMurray explores the future of aldosterone-targeted therapy with aldosterone synthase inhibitors (ASIs). He reviews promising hypertension data for agents such as baxdrostat and outlines large-scale ongoing trials investigating ASIs in HFrEF, HFpEF, CKD, and heart failure prevention, pointing toward a major shift in proactive cardiorenal care.
The session concludes with a dynamic panel discussion addressing potassium thresholds, binder selection, chronic vs acute hyperkalaemia tolerance, insights from the PODCAST trial, and the scientific rationale behind combining MRAs and ASIs.
Overall, this webinar offers a concise, clinically relevant look at today’s best practices and tomorrow’s innovations in cardiorenal medicine.
For more on emerging strategies in aldosterone inhibition, read Cardiac Failure Review Journal’s Special Focus Issue on “New Mineralocorticoid Receptor Antagonists/Aldosterone Antagonists”.
Key Learning Objectives
- Identify clinical barriers associated with traditional aldosterone management and recognize the impact of hyperkalemia on patient outcomes and treatment adherence
- Evaluate the clinical evidence supporting non-steroidal MRAs, particularly finerenone, and understand their role in modern cardiovascular therapeutic strategies
- Apply practical strategies for implementing breakthrough MRA therapies while managing potassium levels and optimizing patient safety profiles
- Distinguish between different approaches to mineralocorticoid pathway modulation, including receptor antagonism and aldosterone synthesis inhibition
- Integrate evidence-based protocols for MRA therapy selection and monitoring in patients with hypertension and heart failure
- Assess patient-specific factors that influence MRA therapy choice and develop personalized treatment approaches for diverse cardiovascular populations
Target Audience
- Cardiologists and interventional cardiologists managing heart failure and hypertensive patients
- Clinical pharmacologists specializing in cardiovascular therapeutics
- Heart failure specialists and advanced heart failure practitioners
- Cardiovascular medicine fellows and cardiology residents
- Nephrology specialists managing patients with cardiovascular comorbidities
More from this programme
Part 1
Breakthrough Mineralocorticoid Receptor Agonists in Cardiovascular Care
In this expert-led webinar moderated by Dr Vijay Chopra, leading clinicians review current and emerging strategies in aldosterone modulation, hyperkalaemia management, and cardiorenal therapeutics.
Dr Javed Butler opens with a practical overview of aldosterone’s central role in heart failure and CKD, emphasising the importance of achieving guideline-directed RAAS inhibitor and MRA dosing. He outlines real-world barriers posed by hyperkalaemia and provides clear strategies to maintain life-saving therapy safely, including the use of modern potassium binders.
Dr Dinesh Khullar presents the clinical evidence for finerenone, a non-steroidal MRA with improved selectivity and a lower risk of hyperkalaemia. He summarises key findings from FIDELITY, CONFIDENCE, and FINEARTS-HF, demonstrating meaningful reductions in CKD progression, heart failure events, albuminuria, and cardiovascular risk, particularly when combined with SGLT2 inhibitors.
Prof John McMurray explores the future of aldosterone-targeted therapy with aldosterone synthase inhibitors (ASIs). He reviews promising hypertension data for agents such as baxdrostat and outlines large-scale ongoing trials investigating ASIs in HFrEF, HFpEF, CKD, and heart failure prevention, pointing toward a major shift in proactive cardiorenal care.
The session concludes with a dynamic panel discussion addressing potassium thresholds, binder selection, chronic vs acute hyperkalaemia tolerance, insights from the PODCAST trial, and the scientific rationale behind combining MRAs and ASIs.
Overall, this webinar offers a concise, clinically relevant look at today’s best practices and tomorrow’s innovations in cardiorenal medicine.
Faculty Biographies
John JV McMurray
Professor of Cardiology
Prof John McMurray is Professor of Medical Cardiology and Deputy Director of the Institute of Cardiovascular and Medical Sciences at the University of Glasgow, and honorary Consultant Cardiologist at the Queen Elizabeth University Hospital, Glasgow. A graduate of Manchester University, Prof McMurray completed postgraduate research at the University of Dundee.
Prof McMurray is a Fellow of the European Society of Cardiology (ESC), American College of Cardiology and American Heart Association as well as the medical Royal Colleges in Edinburgh and Glasgow and the Royal Society of Edinburgh and UK Academy of Medical Sciences.
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