For a patient with resistant hypertension on maximally tolerated ACEi/CCB/thiazide (eGFR 55, K+ 4.6), do you now reach for baxdrostat as the fourth agent — or does PATHWAY-2-proven, pennies-a-day spironolactone remain first-line, with baxdrostat reserved for those who fail or can't tolerate an MRA, given baxdrostat has only Phase 3 BP-lowering data (BaxHTN) and no CV outcomes, no head-to-head vs spironolactone, and unproven hyperkalemia advantage at this eGFR?
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For a patient with resistant hypertension on maximally tolerated ACEi/CCB/thiazide (eGFR 55, K+ 4.6), do you now reach for baxdrostat as the fourth agent — or does PATHWAY-2-proven, pennies-a-day spironolactone remain first-line, with baxdrostat reserved for those who fail or can't tolerate an MRA, given baxdrostat has only Phase 3 BP-lowering data (BaxHTN) and no CV outcomes, no head-to-head vs spironolactone, and unproven hyperkalemia advantage at this eGFR? | Synapse Debates