To Treat or Not to Treat? Watchful Waiting or Oral Antihypertensives for Asymptomatic Inpatient Hypertension #nephsky #nephrology www.nejm.org/doi/full/10....

Ahead of #KidneyWk25, we are recruiting a hypertension fellow to the Stanford Hypertension Center for July 2026. Please come find me at ASN. med.stanford.edu/nephrology/e...

Samir Parikh gives an update on lupus nephritis. #KidneyWk Looking for rapid reduction of proteinuria? Voclosporin is faster, but belimumab showed similar separation from placebo, it just takes longer due to mechanism of action.

BaxHTN phase 3 trial: Aldosterone dysregulation is considered a key driver of hard-to-control hypertension. Research findings on baxdrostat, a highly selective, potent aldosterone synthase inhibitor, in hard-to-control hypertension are summarized in a new Quick Take video. nej.md/3KCsQGJ

Donate and represent! #NephJC

Our @ukkidney.org guidelines here in BMC Nephrology. 💯% agree that in-unit BP should ONLY be used for determining safety of individual HD sessions and NOT long-term CV risk modification. But changing practice will be a long haul. link.springer.com/epdf/10.1186...

Subclinical primary aldosteronism is an under-recognized driver of cardiovascular risk. Could it be a new target for CV prevention? Read our Circulation editorial —>

#NephJC is a labor of a passionate volunteer team that believes education should be accessible, no matter where you are from in the world. Even if editorial team donates unlimited hours of sleep, there are still costs to cover 💸 (👇 blog) 😊 Be kind, help us to #NephItForward #Medsky #Nephsky

We are thrilled to announce that we have generously received funding for a one-year hypertension fellowship, and we are recruiting now for a candidate to start fellowship July 1, 2026 . med.stanford.edu/hypertension/e… -Jehan Zahid Bahrainwala HTN Fellowship Program Director

It's that time of year again 🍂🍂🍂 The #NephJC Fall pledge drive. Plese give if you are able to support our decades long mission of #FOAMed for all. #NephSky #MedSky www.nephjc.com/news/2025/9/22/nephjc-fall-pledge-drive

🚨 Survey Alert! Standardized office BP measurements are recommended everywhere, but still underused. We want to hear from you: what are the barriers to using them as a routine in clinical practice? Click here to read the consent form and take the survey: redcap.link/barriers.to....

My guess is at least 500 #doctors at my #hospital are on H1B visas including at least a few dozen #hospitalists, and if we lose even a handful to other countries our house of cards #healthcare system will fall apart, let alone all 500+

Some of my opinions here on @ajkd.bsky.social Blog; ajkdblog.org/2022/01/19/b... The @ahascience.bsky.social also has a scientific statement here from 2023 www.ahajournals.org/doi/full/10.... #NephJC Catch up

Reposting this again - very relevant for #NephJC discussion on the new AHA/ACC guidelines.

❤️Check out the VA for the discussion on the AHA/ACC Hypertension Guidelines 9/16/25 at 9pm EST by @sejalplakhani.bsky.social #NephJC #NephSky #MedSky www.nephjc.com/news/2025/9/ahaacc-htnguide

To accompany the new ACC/AHA BP guidelines, a practical guide on how to test for Primary Aldosteronism: now recommended for most people with hypertension. www.jacc.org/doi/10.1016/...

Confirmatory testing (aldosterone suppression testing) for primary aldosteronism: not reliable, or reproducible, for diagnosis or predicting lateralization. Sensitivity at the expense of specificity, and vice-versa. Time to simplify the process academic.oup.com/ejendo/artic...

Excellent summary of the ACHIEVE trial from @drsaivani.bsky.social & @thekidneywhisperer.bsky.social #NephJC chat tomorrow www.nephjc.com/news/achieve

#WeekendReads from #EditorsChoice Can you have normal looking adrenal glands with primary aldosteronism? 🔗 academic.oup.com/ajh/article/... 🔓

The era of ASIs is slowly dawning www.nejm.org/doi/full/10.... (Yeah spironolactone is just as good and cheaper) Disclosure: we recruited patients for this one

❓What’s new in BP care? 🎥 Watch the #TargetBP webinar on the 2025 @AHAScience / @ACCinTouch Hypertension Guidelines w/ @drwanpen.bsky.social , @jordybc.bsky.social , Keith Ferdinand, & Dan Jones 👉 targetbp.org

The CPC from last @ahascience.bsky.social #HypertensionSessions now published in @ahajournals.bsky.social www.ahajournals.org/doi/10.1161/... thanks to @drjmluther.bsky.social and all the education editors for the invite We hope it makes for an educational read!

More on Hydra-ANCA-zine Four cases, and review of previous (~ 169) cases reported in the literature academic.oup.com/ckj/article-... in @ckj-era.bsky.social #NephSky #Hydralazine

Commentary on expanded screening for primary aldosteronism in the new HTN guideline. www.ahajournals.org/doi/10.1161/... 🔓

Nice to see new AHA HTN guidelines emphasizing albuminuria detection! "[Urine ACR] (a test that assesses kidney health) is now recommended for all patients with high blood pressure. It was recommended as an optional test in the 2017 guideline." newsroom.heart.org/news/new-hig...

Some key changes that stood out to me (got the opportunity to help w writing these!): 1) Stronger recs for single pill combos 2) Broader recs for screening for primary aldo (now consider in anyone with stage 2 HTN — i.e., BP >=140/90) 3) Just. Say. No… to cuffless BP devices… and to EtOH 2/

The AHA/ACC have released the 2025 High Blood Pressure Guideline, emphasizing prevention and early treatment to reduce cardiovascular disease risk. Read the Guideline in #Hypertension & #Circulation and check out our hub with commentaries and more: www.ahajournals.org/guidelines/h... #Cardiosky

That’s exactly our point - the Spanish data made no sense www.nephjc.com/news/chronot... IMO use long acting meds once a day and timing does not matter

2025 AHA/ACC Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults 08/28/25 @ 12:00 pm – 1:30 pm CDT Featuring writing committee members and highlights from the ACC/AHA Committee on Clinical Practice Guidelines targetbp.org/event/target...

We screen everyone referred to our hypertension program for many years now We don’t refer anyone to endo Most patients just need Spiro The occasional peeps need AVS and few need an adrenalectomy Confirmatory tests are useless

Indeed I suspect these guidelines are trying to shift the Overton window (did I use the phrase correctly 😎 @jordybc.bsky.social ?) - I don’t think PCPs read the JCEM! Right now even referral centres nephrologists, endocrinologists, cardiologists are doing a shitty job of screening 🤷🏽‍♂️

New Primary Aldosteronism Guidelines - simpler, streamlined, and hopefully more pragmatic academic.oup.com/jcem/advance...

New PA Endo guideline is also out by experts @anandvaidya17.bsky.social #Cardiosky @hswapnil.medsky.social doi.org/10.1210/clin...

Our latest clinical practice guideline, Primary Aldosteronism (bit.ly/44MbrSv), is now available. The new guideline recommends more widespread screening for a common hormonal cause of high blood pressure known as primary aldosteronism. Read in @endocrinenews.bsky.social: bit.ly/4kFadhv #ENDO2025

In 15 patients with primary aldosteronism, baxdrostat (a second-generation, nonimidazole aldosterone synthase inhibitor) resolved or reduced the severity of hypertension, excessive aldosterone production, and hypokalemia. Full SPARK study results: nej.md/40Js1kz #ENDO2025

Our new data on subclinical PA and MACE is out in Circulation! For the first time, we show that renin-independant aldosterone production is associated with an increased risk of MACE independently of BP, in people mostly normotensive with low CV risk. www.ahajournals.org/doi/full/10....

Detailed results from the pivotal P3 Launch-HTN trial were published today in @jama.com, reinforcing lorundrostat’s efficacy in a real-world setting. Read our press release to learn more: ir.mineralystx.com/news-events/... #BloodPressure #Cardiology #Cardiosky #MLYS

#WeekendReads blast from the past archives of #EditorsChoice 🔗 academic.oup.com/ajh/article/... Could renin guided therapy be cost effective? From 2013, but still very relevant?

How much do beta blockers help after a heart attack — even when the heart’s pumping well? The latest episode of Beyond Journal Club from @coreimpodcast.bsky.social & NEJM Group explores the REDUCE-AMI trial, which questions whether beta blockers are still needed for all. Listen now: nej.md/4ekdlxX

Should adrenalectomy still be first-line treatment of unilateral PA? ▶️adrenalectomy associates with greater decrease in LVM despite similar BP ▶️shorter duration of HTN associates with greater benefit after surgery ▶️high 24hr urine Na negatively impacts benefit of MRA tiny.cc/jf2o001 🔒 #nephsky

#ThrowbackThursday From the highly cited collection, so #free to read! 🔗 academic.oup.com/ajh/article/... 🔓

The first #ERA25 simultaneous pub CONFIDENCE trial of empagliflozin + finerenone in N = 579 Greater reduction in ACR and BP Note the impressive GFR dip www.nejm.org/doi/full/10....

1/ Interesting read. The conclusion to use MRAs (or maybe ASIs) sooner makes sense to me. But is the main benefit just due to the high prevalence of primary aldosteronism, rather than in offsetting the secondary aldosteronism that accompanies thiazides? #nephsky #cardiosky #endosky #medsky

Also glad they came up with an antidote! Hoping to see it tested for safety in humans www.ahajournals.org/doi/10.1161/... (personally, I wouldn’t feel comfortable prescribing this without a way to reverse it, e.g., for sepsis or pregnancy)

Looking forward to the next phase 2 trial results for a deeper dive into how this fares in higher risk patients, which I’m guessing is holding up the plans for a larger phase 3 trial clinicaltrials.gov/study/NCT062... 4/

Phase 2 trial of the new antihypertensive agent, ultra-long-acting (q6 month), subq, small interfering RNA against angiotensinogen (Zilebesiran), hit JAMA! h/t @drjmluther.bsky.social jamanetwork.com/journals/jam... 1/

Major Trials in the use of ASIs targeting difficult-to-control hypertension #NephJC

As data emerges, the 3 new agents are much more selective than prior drugs. Still need more data on Vicadrostat (done but not shown in publications). #nephJC

Note that aldosterone escape refers to escape from the effects of aldosterone under some conditions And aldosterone breakthrough is the term for continued aldosterone production despite renin-angiotensin blockade

So we should remove diastolic targets from guidelines no? @hswapnil.medsky.social