REN and hydrops fetalis: Spironolactone 25–50 mg/day reduced systolic BP by 12.8 mmHg over 12 weeks, surpassing the effects of bisoprolol (5–10 mg/day) and modified-release doxazosin (4–8 mg/day).11 In the mechanistic sub-study, patients with lower plasma renin, higher aldosterone, and higher aldosterone-to-renin ratio, indicative of renin-independent aldosteronism, experienced greater reductions in systolic BP with spironolactone.12 Similar findings were observed in 527 patients at risk for HF from the HOMAGE trial.