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Updated: Aug 26, 2025

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Novel Therapies on the Horizon of Hypertension Management
Olivia Blazek1, George L Bakris1
1Department of Medicine, American Heart Association Comprehensive Hypertension Center, University of Chicago Medicine, Chicago, IL 60637, USA.
Insights
New therapies are needed for resistant hypertension (RH), affecting 13.7% of patients. This review explores emerging pharmacologic and procedural treatments to combat worsening uncontrolled hypertension and cardiovascular outcomes.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Pharmacology
Background:
- Uncontrolled hypertension and associated cardiovascular outcomes are increasing.
- Resistant hypertension (RH) affects an estimated 13.7% of patients despite available medications.
- Novel therapeutic strategies are essential to manage the rising prevalence of hypertension.
Approach:
- A systematic literature review was conducted to identify emerging treatments for RH.
- Six distinct pharmacologic classes and two procedural interventions were evaluated.
- Pharmacologic agents include mineralocorticoid receptor antagonists and hepatic angiotensinogen attenuators.
- Procedural interventions focus on renal denervation and baroreceptor activity enhancement.
Key Points:
- Emerging pharmacologic classes target novel pathways for hypertension management.
- Procedural interventions offer alternative approaches for difficult-to-control hypertension.
- Research is expanding the therapeutic options for essential hypertension and RH.
Conclusions:
- Promising new medications and procedural interventions are under development for hypertension.
- These advancements aim to broaden treatment options for patients with uncontrolled hypertension and RH.
- Further research will enhance the clinical arsenal against resistant hypertension.
Background:
The rates of uncontrolled hypertension, along with downstream cardiovascular outcomes, has been worsening in this country. Despite the plethora of antihypertensive medications on the market, the prevalence of resistant hypertension (RH) is estimated to be 13.7%. Therefore in addition to increased clinical education and focus on lifestyle management of hypertension and medication compliance, new therapies are needed to address this rise in hypertension.
Methods:
A systematic review of the available medical literature was performed to identify emerging treatment options for RH.
Results:
Six different pharmacologic classes and 2 procedural interventions were identified as being appropriate for review in this paper. The pharmacologic classes to be explored are non-steroidal mineralocorticoid receptor antagonists, aminopeptidase A inhibitors, dual endothelin antagonists, aldosterone synthetase inhibitors, atrial natriuretic peptide inhibitors, and attenuators of hepatic angiotensinogen. Discussion of procedural interventions to lower blood pressure will focus on renal denervation and devices that increase carotid baroreceptor activity.
Conclusions:
Promising medication and procedural interventions are being developed and studied to expand our treatment arsenal for patients with uncontrolled essential hypertension and RH.
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