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Published on: June 7, 2013
Novel therapeutic targets for hypertension
1Center for Cardiovascular Research, Charité-Universitätsmedizin, Hessische Strasse 3-4, 10115 Berlin, Germany.
Nature Reviews. Cardiology
|June 23, 2010
Summary
New research explores innovative treatments for hypertension and cardiovascular risk reduction beyond current therapies. Promising avenues include targeting the renin-angiotensin-aldosterone system (RAAS) and novel surgical interventions like renal denervation.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Nephrology
Background:
- Established hypertension therapies exist, yet unmet needs remain for resistant hypertension and enhanced cardiovascular risk reduction.
- Current treatments often target the renin-angiotensin-aldosterone system (RAAS), with newer agents like eplerenone and aliskiren demonstrating efficacy.
- Further risk reduction beyond blood pressure lowering is a key objective for novel therapeutic strategies.
Purpose of the Study:
- To review emerging and novel therapeutic targets for hypertension and cardiovascular risk reduction.
- To explore the potential of modulating the renin-angiotensin-aldosterone system (RAAS) and other pathways for improved patient outcomes.
- To assess the clinical viability of new pharmacological agents and interventional procedures.
Main Methods:
- Literature review of current and emerging antihypertensive strategies.
- Analysis of novel therapeutic targets within the RAAS and related systems.
- Evaluation of minimally invasive surgical techniques, such as renal denervation.
Main Results:
- Novel RAAS-related targets include angiotensin II type 2 receptor stimulation, renalase supplementation, and aldosterone synthase inhibition.
- Combined angiotensin-converting-enzyme and neutral endopeptidase blockade shows potential but carries risks like angioedema.
- A (pro)renin-receptor blocker may address angiotensin-independent actions of renin, and renal denervation offers a surgical option for resistant hypertension.
Conclusions:
- Several novel strategies targeting the RAAS and other pathways show promise for hypertension management and cardiovascular risk reduction.
- Further clinical investigation is required to determine the ultimate value and safety of these emerging therapies.
- Minimally invasive renal denervation presents a potential option for patients with difficult-to-treat resistant hypertension.
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