Swapnil Hiremath 🍁🇨🇦 @hswapnil.medsky.social · 17/04/2026I am with Mike - but locally influenced by Greg Hundemer’s work showing unsuppressing renin is associated with better outcomes - while we await RCT data from @goupilremi.bsky.social and Greg 250
Josh Leisring @joshleisring.bsky.social · 17/04/2026I agree with this. Although it's based on observational data (so far), using renin as a biomarker when medically treating PA is part of the endo society guideline. I titrate MRA until renin rises, then if needed utilize A/C/D. tinyurl.com/yksmf5y8 252
Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026And why not do mra/thz first? Why just mra alone? I guess that's the magic... If you get a good response upfront you use fewer agents. But if you dont, couldnt that imply secondary htn where additional classes might help? 120
Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026Thank you! Are you aware of an ongoing trial testing this? 100
