Hypertension and Lorundrostat: Key Discoveries From the TARGET-HTN Trial

Hypertension, characterized by persistent high blood pressure levels, is a major global health concern, contributing significantly to the risk of cardiovascular diseases (CVD) and overall mortality. It is classified into primary and secondary hypertension, with its prevalence steadily increasing due to ageing populations and unhealthy lifestyle factors. The World Health Organization (WHO) reports a staggering rise in hypertension cases, affecting one in 3 adults worldwide, doubling from 1990 to 2019. A significant development in the field of hypertension treatment is the Target-HTN trial, which investigated the efficacy of lorundrostat, an aldosterone synthase inhibitor, in reducing systolic blood pressure. This trial involved 2 cohorts. Cohort 1, comprising patients with suppressed plasma renin activity and elevated serum aldosterone levels, showed promising results. Lorundrostat doses of 100 mg and 50 mg administered once daily led to substantial reductions in systolic blood pressure compared to a placebo group. Cohort 2, although considered exploratory, also exhibited a notable reduction in systolic blood pressure with a 100 mg once-daily dose of lorundrostat. In conclusion, the Target-HTN trial has demonstrated that lorundrostat, an aldosterone synthase inhibitor, holds promise as an innovative therapeutic approach for reducing systolic blood pressure, especially in hypertensive patients with suppressed plasma renin activity and elevated serum aldosterone levels. These findings advocate for the initiation of Phase 3 trials to further validate the safety and efficacy of lorundrostat in a larger and more diverse patient population.