{"doi":"10.1210/jendso/bvab175","title":"Evaluation of Mineralocorticoid Receptor Antagonism on Changes in NT-proBNP Among Persons With HIV","abstract":"Abstract Subclinical myocardial dysfunction is prevalent among well-treated persons with HIV (PWH). We have previously demonstrated unique renin-angiotensin-aldosterone system physiology among PWH with metabolic dysregulation. Mineralocorticoid receptor blockade may be a targeted treatment strategy for subclinical heart disease in PWH. Forty-six PWH were randomized to receive either eplerenone 50 mg daily or placebo in a 6-month randomized, double-blinded, placebo-controlled trial. We assessed changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP), a biomarker of cardiac stretch, under controlled posture and dietary conditions. The eplerenone- and placebo-treated groups demonstrated a long duration of HIV with good immunological control. NT-proBNP levels were similar between the groups at baseline (41.1 [20.2, 97.9] vs 48.9 [29.2, 65.4] ng/L, P = .80) and decreased significantly more in the eplerenone- vs placebo-treated groups after 6 months (change NT-proBNP -9.6 [-46.8, 0.3] vs -3.0 [-17.0, 39.9] ng/L, P = .02 for comparison of change between groups). Decreases in NT-proBNP were independent of changes in systolic and diastolic blood pressure, and related to decreases in high-sensitivity C-reactive protein (ρ = 0.32, P = .05) and inversely to increases in serum aldosterone (ρ = -0.33, P = .04) among all participants. Treatment with eplerenone for 6 months vs placebo significantly decreases NT-proBNP levels among PWH, independent of eplerenone’s known blood pressure-lowering effects. Further studies should elucidate whether lowering NT-proBNP in this at-risk metabolic population with subclinical heart disease will offer cardioprotection. Clinical Trial Registration NCT01405456","journal":"Journal of the Endocrine Society","year":2021,"id":212479,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.954,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT01405456"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":278980,"name":"Christopher R. deFilippi","orcid":"0000-0002-0660-4943","position":1,"is_corresponding":false},{"id":381594,"name":"Kathleen V. Fitch","orcid":"0000-0002-0541-3707","position":2,"is_corresponding":false},{"id":382352,"name":"Sanjna Iyengar","orcid":null,"position":3,"is_corresponding":false},{"id":802786,"name":"Grace Shen","orcid":"0000-0001-6023-8764","position":4,"is_corresponding":false},{"id":282163,"name":"Tricia H. Burdo","orcid":"0000-0002-4224-7381","position":5,"is_corresponding":false},{"id":802787,"name":"Allie R. Walpert","orcid":"0000-0002-0810-423X","position":6,"is_corresponding":false},{"id":764525,"name":"Teressa S Thomas","orcid":"0000-0003-1803-8392","position":7,"is_corresponding":false},{"id":419661,"name":"Gail K. Adler","orcid":"0000-0003-3506-7347","position":8,"is_corresponding":false},{"id":12007,"name":"Steven Grinspoon","orcid":"0000-0002-6338-000X","position":9,"is_corresponding":false},{"id":381597,"name":"Suman Srinivasa","orcid":"0000-0003-1950-4770","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-18T23:52:27.434608Z","pmid":"34909518","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}