A post hoc analysis of the FINEARTS-HF trial finds that finerenone (Kerendia) delivers early and sustained systolic blood pressure reductions in patients with heart failure with moderately reduced or preserved ejection fraction. Crucially, the drug's cardiovascular benefits were consistent across all baseline blood pressure levels, and its safety profile remained solid. The FDA approved finerenone for these HF types in 2025.
Finerenone, the nonsteroidal mineralocorticoid receptor antagonist already FDA-approved for certain types of heart failure, is now showing an added perk: meaningful blood pressure reduction. A post hoc analysis of the landmark FINEARTS-HF trial, published in JAMA Cardiology, found that finerenone produced early and sustained drops in systolic BP — as soon as one month into treatment — in patients with heart failure with moderately reduced ejection fraction (HFmrEF) or preserved ejection fraction (HFpEF).
Importantly, the drug's cardiovascular benefits — a 16% reduction in CV death and worsening HF vs. placebo — held steady regardless of patients' baseline blood pressure, suggesting the BP-lowering effect isn't what's driving the cardiac protection. Safety was also consistent across the BP spectrum, with no increased risk of serious adverse events.
By the Numbers
Why it matters: Since hypertension affects ~90% of HFmrEF/HFpEF patients, understanding finerenone's BP effects is clinically critical. This analysis reassures clinicians that finerenone's heart failure benefits are independent of BP lowering — making it a viable option across a broad range of patients.
