Heart failure & cardiomyopathies
Finerenone-Related Risk of Hypotension in Heart Failure With Mildly Reduced or Preserved Ejection Fraction
Authors' conclusion
In this prespecified analysis of the FINEARTS-HF trial, finerenone led to higher rates of post-baseline SBP <100 mm Hg and investigator-reported hypotension.
Study context
- Population
- Symptomatic patients with chronic HF and LVEF ≥40%with available data
- Participants
- 5,815 patients
- Comparison
- Finerenone vs placebo
- Primary endpoint
- Composite of:
- Total HF events
- CV death
Methodological detailsprespecified analysis, placebo-controlled
- Prespecified analysis
- Placebo-controlled
Primary result
As reported in the abstract
Finerenone
- Systolic blood pressure (SBP) <100 mm Hg
- 538
- Investigator-reported hypotension
- 225
Placebo
- SBP <100 mm Hg
- 361
- Investigator-reported hypotension
- 139
Systolic blood pressure (SBP) <100 mm Hg
Finerenone538
Placebo361
Investigator-reported hypotension
Finerenone225
Placebo139
Finerenone vs PlaceboOdds ratio (95% CI)
SBP <100 mm Hg (899 total)
1.60(1.38–1.85)
Investigator-reported hypotension (364 total)
1.67(1.34–2.08)
Further findings
Treatment-related risk of primary endpoint, by SBP <100 mm Hg (no/before vs after)
- No/before SBP <100 mm Hg: rate ratio
- 0.78 (0.67-0.90) (95% CI)
- After SBP <100 mm Hg: rate ratio (95% CI), appeared to attenuate
- 0.99 (0.70-1.39)
- No formal statistical interaction (Pinteraction = 0.33)
Original publication
Finerenone-Related Risk of Hypotension in Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JACC Heart Fail. Published 9 December 2025. doi:10.
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