eng Oriental Scientific Publishing Company Biomedical and Pharmacology Journal 0974-6242 2025-09-30 18 3 1824 1834 10.13005/bpj/3217 67240 article Monisha Prasad 1 Sulthan Al-Rashid 2 Vinjmur Ragavan Yashvanthan 2 Bruhan Math Prakash 4 Malarveni Damodaran Lakshmi Priya 5 Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India Department of Pharmacology, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India Department of Pharmacology, Andaman and Nicobar Islands, Institute of Medical Sciences, India Department of Biochemistry, Auxilium College (Autonomous),Vellore, Tamil Nadu, India This review explores the mechanistic role of finerenone, a selective nonsteroidal mineralocorticoid receptor (MR) antagonist, in the management of hypertension. Finerenone exerts its antihypertensive effects by selectively targeting MR pathways, thereby modulating blood pressure and offering substantial cardiorenal protection. By inhibiting aldosterone activity within the renin–angiotensin–aldosterone system, it reduces sodium and water retention, oxidative stress, fibrosis, and inflammation in renal and cardiovascular tissues. This narrative review is based on a comprehensive analysis of peer-reviewed preclinical and clinical studies retrieved from databases such as PubMed and Scopus, using terms including “finerenone,” “hypertension,” “mineralocorticoid receptor antagonists,” and “cardiorenal protection.” The review highlights finerenone’s superior efficacy and safety profile compared to traditional MR antagonists such as spironolactone. These findings underscore its potential to reduce blood pressure and prevent hypertension-induced organ damage with fewer adverse effects. The dual action of finerenone in blood pressure regulation and organ protection positions it as a promising therapeutic candidate. Ongoing research is warranted to further optimize its clinical applications in hypertension and related complications. https://biomedpharmajournal.org/vol18no3/mechanistic-understanding-of-finerenone-in-hypertension-management-a-narrative-review/ Antihypertensive Blood Pressure regulation Cardiovascular Finerenone Hypertension Mineralocorticoid Receptor Renal Protection Renin-angiotensin-aldosterone system