[Therapeutic novelties in the management of arterial hypertension]

Arterial hypertension is one of the major risk factors for the development of cardiovascular diseases such as heart failure, ischemic heart disease, chronic kidney disease and cerebrovascular events. Adequate blood pressure control is vital for the management of patients with vascular disease. New therapeutic alternatives are appearing on the horizon to improve the degree of blood pressure control in these patients, such as direct renin inhibitors, beta-blockers with additional properties, carotid receptor- stimulating devices and vaccination against arterial hypertension. Direct renin inhibitors are a new family of antihypertensive drugs that have so far shown a good antihypertensive effect and an additive effect on reduction of proteinuria in patients with diabetic nephropathy. Recent meta-analyses suggest that betablockers used as first-line treatment for uncomplicated arterial hypertension could have a less beneficial effect on the development of cardiovascular disease than other antihypertensive drugs. However, the emergence of new subtypes of beta-blockers with other hemodynamic and metabolic properties could change this conception. Carotid receptor-stimulating devices and vaccination against arterial hypertension, although not totally new therapies, are being revitalized, with preliminary results that suggest that they could be used for the treatment of arterial hypertension in patients with a specific profile. Although scientifically stimulating, the long-term beneficial effects of these new therapeutic alternatives on target-organ protection still need to be confirmed.