Evidence mapPaperPMID 39394512Full record

ArticleHypertension research : official journal of the Japanese Society of Hypertension2025

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.

Kazuomi Kario, Hiroyuki Ohbayashi, Masami Hashimoto, Naoki Itabashi, Mitsutoshi Kato, Kazuaki Uchiyama, Kunio Hirano, Noriko Nakamura, Takahide Miyamoto, Hirotaka Nagashima and 10 more

Abstract readEquivalence TrialMulticenter Study
In one paragraph

Article in Hypertension research : official journal of the Japanese Society of Hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Kazuomi KarioDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan. kkario@jichi.ac.jp.
Hiroyuki OhbayashiTohno Chuo Clinic, Mizunami, Gifu, Japan.
Masami HashimotoHashimoto Kidney Clinic, Fukuyama, Hiroshima, Japan.
Naoki ItabashiItabashi Diabetes and Dermatology Medical Clinic, Koga, Ibaraki, Japan.
Mitsutoshi KatoKato Clinic of Internal Medicine, Katsushika-ku, Tokyo, Japan.
Kazuaki UchiyamaUchiyama Clinic, Joetsu, Niigata, Japan.
Kunio HiranoHirano Clinic, Morioka, Iwate, Japan.
Noriko NakamuraPrimula Clinic, Kagoshima, Kagoshima, Japan.
Takahide MiyamotoMiyamoto Clinic of Internal Medicine, Matsumoto, Nagano, Japan.
Hirotaka NagashimaTokyo Center Clinic, Chuo-ku, Tokyo, Japan.
Hidenori IshidaAkaicho Clinic, Chiba, Chiba, Japan.
Yusuke EbeEbe Clinic, Nagaoka, Niigata, Japan.
Tsuguru HattaHatta Medical Clinic, Kyoto, Kyoto, Japan.
Toshiki FukuiOlive Takamatsu Medical Clinic, Takamatsu, Kagawa, Japan.
Tatsuo ShimosawaDepartment of Clinical Laboratory, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan.
Tomohiro KatsuyaKatsuya Clinic, Amagasaki, Hyogo, Japan.
Takashi TaguchiPrimary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co. Ltd., Chuo-ku, Tokyo, Japan.
Ayumi TanabeData Intelligence Department, Daiichi Sankyo Co. Ltd., Shinagawa-ku, Tokyo, Japan.
Mitsuru OhishiDepartment of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Kagoshima, Japan.
EXCITE-HT investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This prespecified subanalysis of the multicenter, randomized, open-label, parallel-group EXCITE-HT study aimed to examine the non-inferiority of esaxerenone to trichlormethiazide as a second-line antihypertensive agent according to the basal antihypertensive agent used (angiotensin receptor blocker [ARB] or calcium channel blocker [CCB]). 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]: -1.3 [-3.8, 1.3]/-0.2 [-1.6, 1.3] mmHg for ARB; -2.7 [-4.2, -1.2]/-0.8 [-1.7, 0.1] mmHg for CCB). The respective incidences of serum potassium levels <3.5 mEq/L and ≥5.5 mEq/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 ≥7.0 mg/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. A subgroup analysis of the EXCITE-HT study according to basal antihypertensive agent demonstrated the non-inferiority of esaxerenone to trichlormethiazide in lowering morning home BP regardless irrespective of the basal antihypertensive agent. Esaxerenone with a CCB showed superiority to trichlormethiazide in lowering SBP, without any new safety concerns.

Indexed as

Angiotensin Receptor AntagonistsAntihypertensive AgentsBenzoatesBlood PressureCalcium Channel BlockersHypertensionTrichlormethiazideAgedFemaleHumansMaleMiddle AgedPyrrolesSulfonesTreatment OutcomeAngiotensin Receptor AntagonistsAntihypertensive AgentsBenzoatesCalcium Channel BlockersesaxerenonePyrrolesSulfonesTrichlormethiazideAngiotensin II receptor blockersCalcium channel blockersEsaxerenoneEssential hypertensionTrichlormethiazide

Identifiers

PMID39394512
PMCPMC11794140

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.