Re-Analysis and Correction of Pooled Diastolic Data in Alper et al. Meta-Analysis on Baxdrostat

We identified methodological and data extraction errors in a recently published meta-analysis evaluating baxdrostat in resistant and uncontrolled hypertension. Specifically, Figure 1B incorrectly interchanges the baxdrostat and placebo groups in the BrigHTN trial and fails to combine all baxdrostat dose arms, contrary to the authors’ stated methodology. Reanalysis of the five included trials using the published supplementary data and the original statistical approach (random-effects model, REML estimation) revealed a statistically significant reduction in seated diastolic blood pressure with baxdrostat compared with placebo (mean difference −3.00 mmHg, 95% CI −4.86 to −1.14; P = 0.002; I² ≈ 67%), contrasting with the nonsignificant result originally reported (−1.82 mmHg, 95% CI −5.24 to 1.59; P = 0.30; I² = 88%). Excluding the HALO trial eliminated statistical heterogeneity (I² = 0%). Additional discrepancies concern the standard deviation reported for HALO and the definition of blood pressure response in BrigHTN. These findings warrant a formal correction of the published meta-analysis.