Imamura et al. conducted a small-scale clinical study using esaxerenone alone; they administered esaxerenone to 33 patients with chronic heart failure (HFpEF) complicated by hypertension and reported that esaxerenone significantly reduced systolic blood pressure, left ventricular weight index, and BNP concentrations and may have a beneficial effect on reverse remodeling in patients with HFpEF [33]. This evidence concerns the gene NPPB and congestive heart failure.