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Open research questions in Hormonal Regulation and Hypertension

106 unresolved questions extracted from the limitations and future-work sections of 428 Hormonal Regulation and Hypertension papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Establishing the efficacy of finerenone in treating liver fibrosis will require more high-quality clinical studies, - Investigating the antifibrotic efficacy of MR antagonism depending on the underlying liver disease etiology

    Mineralocorticoid Receptor Antagonists for Liver Fibrosis: Potential Mechanisms and Research Progress · 2026 · DOI

  • Limited effective antifibrotic strategies for liver fibrosis. Limited clinical evidence supporting MRAs as antifibrotic therapies in liver disease. Insufficient pharmacokinetic data in advanced liver disease.

    Mineralocorticoid Receptor Antagonists for Liver Fibrosis: Potential Mechanisms and Research Progress · 2026 · DOI

  • Primary aldosteronism screening remains suboptimal due to the high technical demands of aldosterone-to-renin ratio measurement and poor patient compliance. There is a need for a more accessible and effective screening tool for primary aldosteronism.

    The nomogram prediction model for primary aldosteronism: the combination of serum and urine electrolytes and serum uric acid · 2026 · DOI

  • investigating the effects of hormonal contraceptives on cognitive performance, - examining the relationship between oestradiol and cognitive function in different populations, - comparing cognitive performance between women in different menstrual cycle phases

    Menstrual Cycle Phase Influences Cognitive Performance in Women and Modulates Sex Differences: A Combined Longitudinal and Cross-Sectional Study · 2025 · DOI

  • the challenge of establishing a new standard of care that balances the benefits and risks of RAAS inhibition - the need to individualize treatment approaches for patients with different needs and characteristics - the potential for adverse effects, such as hyperkalemia and gynecomastia, with certain RAAS inhibitors

    Renin–Angiotensin–Aldosterone System: From History to Practice of a Secular Topic · 2024 · DOI

  • combining two or more RAAS-inhibiting agents seemed to show more harm than benefit - even if treated with a single RAAS inhibitor, older patients with CKD can develop normotensive acute kidney injury - the addition of another RAAS inhibitor in patients who did not respond to a first RAAS inhibitor has shown to fail in warranting a full benefit from this drug class

    Renin–Angiotensin–Aldosterone System: From History to Practice of a Secular Topic · 2024 · DOI

  • future simplification of the model for primary care adaptation, - evaluation of the model in a larger population

    The nomogram prediction model for primary aldosteronism: the combination of serum and urine electrolytes and serum uric acid · 2026 · DOI

  • However, data on the interaction of hypercortisolism and T2D are scarce—thus, we aimed to assess the cortisol-associated morbidity and mortality in the context of T2D and adrenal mild autonomous cortisol secretion (MACS).

    Mild autonomous cortisol secretion (MACS) is associated with increased mortality in patients with adrenal adenomas only in the presence of type 2 diabetes: a retrospective cohort study · 2026 · DOI

  • Background The loss of physiological nocturnal blood pressure (BP) decline is a major contributor to cardiovascular risk, yet its endocrine underpinnings in primary aldosteronism (PA) remain underexplored.

    Aldosterone and Impaired Nocturnal Blood Pressure Decline in Primary Aldosteronism · 2026 · DOI

  • BACKGROUND: Clinical trials have indicated that finerenone, a nonsteroidal mineralocorticoid receptor antagonist, elicits considerable cardiovascular protective benefits; however, its precise mechanism of action remains to be fully elucidated.

    Cardioprotective Effects of Finerenone Associated With the Suppression of Myocardial Sodium Accumulation in Aldosterone/Salt‐Loaded Rats · 2026 · DOI

  • However, incomplete ablation of aldosterone-producing adenomas (APA) tissue remains a key limitation.

    Case Report: A hybrid approach of selective adrenal artery and venous embolization for the treatment of unilateral aldosterone-producing adenoma · 2025 · DOI

  • Notable inflammatory and fibrotic changes and differential microRNA (miRNA) expression profiles in the perirenal fat observed in PA may contribute to this increased risk, however, which has not been fully elucidated.

    MicroRNA-24-3p targeting Top1 in perirenal fat is involved in circulating inflammation and high cardiovascular disease risk in patients with primary aldosteronism · 2025 · DOI

  • Mounting evidence suggests that milder forms of renin-independent aldosterone production (subclinical PA) are highly prevalent; however, the link between subclinical PA and MACE remains uncertain.

    Subclinical Primary Aldosteronism and Major Adverse Cardiovascular Events: A Longitudinal Population-Based Cohort Study · 2025 · DOI

  • We acknowledge that the results presented here should be further validated in mechanistic models and prospective randomized trials to address their clinical relevance and how they may impact future clinical practice.

    Finerenone effects on biomarkers: an analysis from the FIGARO-DKD trial · 2025 · DOI

  • Previous studies have suggested that serine carboxypeptidase 1 (Scpep1) is involved in vascular diseases; however, its role in cardiac diseases remains unclear.

    Scpep1 inhibition attenuates myocardial infarction-induced dysfunction by improving mitochondrial bioenergetics · 2025 · DOI

  • The association between KCNJ5 mutations and the risk of developing new-onset diabetes (NOD) in patients with unilateral primary aldosteronism (uPA) remains underexplored.

    Unilateral Primary Aldosteronism Lacking KCNJ5 Somatic Mutations Is Associated With an Elevated Risk of New-Onset Diabetes · 2025 · DOI

  • However, it remains unclear if these drugs should be sequentially or simultaneously initiated in individuals with CKD and T2D.

    1863-LB: The Confidence Trial—Efficacy/Safety of Combining Finerenone with Empagliflozin in People with Chronic Kidney Disease and Type 2 Diabetes · 2025 · DOI

  • However, the molecular mechanisms of AG and SCG during hypertension-induced LVH remain unclear.

    Transcriptome landscape of the adrenal gland and superior cervical ganglion from hypertension-induced left ventricular hypertrophy rat model · 2025 · DOI

  • However, real-world evidence comparing nonsteroidal and steroidal MRAs in HF is lacking.

    Nonsteroidal Versus Steroidal Mineralocorticoid Receptor Antagonists in Heart Failure: Real‐World Evidence From a Multicenter Cohort Study · 2025 · DOI

  • Although cholesterol serves as the primary precursor for aldosterone synthesis, the mechanism governing its supply and metabolism within aldosterone-producing adenomas remains unclear.

    Inhibition of NPC Intracellular Cholesterol Transporter 1 Dually Regulates Aldosterone Secretion Via the Steroidogenic Acute Regulatory‐Related Lipid Transfer Domain‐3‐Voltage‐Dependent Anion Channel 1 Axis and Inositol 1,4,5‐Trisphosphate Receptor Type 3‐Calcium Signaling · 2025 · DOI

  • There are indications that both receptors interact functionally and physically, but the precise role of this interdependence is poorly understood.

    The glucocorticoid receptor potentiates aldosterone-induced transcription by the mineralocorticoid receptor · 2024 · DOI

  • However, the relationship between plasma aldosterone concentrations (PAC) and bone mineral density (BMD) in middle-aged and elderly hypertensive patients remains unclear.

    Correlation between plasma aldosterone concentration and bone mineral density in middle-aged and elderly hypertensive patients: potential impact on osteoporosis and future fracture risk · 2024 · DOI

  • However, it remains unclear whether the metabolomic differences relate solely to the disease-defining hormonal parameters.

    Association of adrenal steroids with metabolomic profiles in patients with primary and endocrine hypertension · 2024 · DOI

  • The primary aldosteronism surgical outcome (PASO) consensus sets uniform standards for postoperative outcomes in unilateral PA, but its setting of thresholds remains controversial.

    Adrenalectomy for primary aldosteronism and its related surgical characteristics · 2024 · DOI

  • However, because of its rarity, characteristics of APA with these mutations have not been well characterized.

    Double somatic mutations in CTNNB1 and GNA11 in an aldosterone-producing adenoma · 2024 · DOI

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106 open questions have been extracted from the limitations and future-work passages of 428 Hormonal Regulation and Hypertension papers in our 4.5M-paper local library. Each one below links back to the study that raised it, so you can read the original claim in context.

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