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Aprocitentan for Blood Pressure Reduction in Black Patients
John M Flack1, Markus P Schlaich2, Michael A Weber3
1Division of General Internal Medicine, Hypertension Section, Departments of Medicine and Population Science and Policy, Hypertension Section, Southern Illinois University School of Medicine, Springfield, IL (J.M.F.).
Hypertension (Dallas, Tex. : 1979)
|January 22, 2025
Summary
Aprocitentan effectively lowered blood pressure (BP) and albuminuria in Black individuals with resistant hypertension. This dual endothelin receptor antagonist shows promise for managing difficult-to-control hypertension in this population.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Nephrology
Background:
- Black individuals experience higher rates of resistant hypertension and cardiovascular risk.
- Resistant hypertension poses a significant challenge in managing cardiovascular health.
- Dual endothelin receptor antagonists are being investigated for their therapeutic potential.
Purpose of the Study:
- To evaluate the blood pressure (BP)-lowering effects of aprocitentan in Black individuals with resistant hypertension.
- To assess the efficacy and safety of aprocitentan in a specific demographic group.
- To compare aprocitentan's effects with placebo in the PRECISION study population.
Main Methods:
- The study enrolled 82 Black individuals from the PRECISION trial.
- Participants received aprocitentan (12.5 mg or 25 mg) or placebo for 4 weeks, followed by extended treatment and re-randomization.
- Blood pressure was monitored using office and 24-hour ambulatory measurements; albuminuria and adverse events were also assessed.
Main Results:
- Aprocitentan demonstrated significant reductions in systolic BP, particularly evident with 24-hour ambulatory monitoring.
- Office BP reductions were observed, with sustained effects during extended treatment and maintenance post-re-randomization.
- Aprocitentan markedly reduced albuminuria, with peripheral edema noted as the most frequent adverse event.
Conclusions:
- Aprocitentan effectively reduces BP and albuminuria in Black individuals suffering from resistant hypertension.
- The drug's efficacy in this population mirrors that observed in the broader PRECISION study cohort.
- Aprocitentan may offer a valuable therapeutic option for managing resistant hypertension in Black individuals.
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