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Overcoming Barriers to Developing and Implementing Novel Therapies for Hypertension
Konstantin A Krychtiuk1, Renato D Lopes1, Victoria A Cargill2
1Duke Clinical Research Institute, Durham, NC (K.A.K., R.D.L., J.B.G., N.J.P., A.F.H., C.B.G.).
Hypertension (Dallas, Tex. : 1979)
|August 28, 2025
Summary
Effective hypertension management is hindered by numerous barriers, yet novel RNA-targeted therapies and device interventions show promise for overcoming these challenges and improving cardiovascular health.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biotechnology
Background:
- Hypertension is a leading modifiable risk factor for global disability and death, disproportionately impacting disadvantaged populations.
- Despite effective therapies, blood pressure control remains low, with recent trends indicating a decline.
- Systemic, patient-related, and healthcare provider barriers impede effective hypertension management.
Purpose of the Study:
- To provide an overview of barriers to effective hypertension treatment.
- To present a framework for clinical trials assessing novel cardiovascular disease risk factor treatments.
- To explore the potential of innovative therapies like RNA-targeted treatments and device-based interventions.
Main Methods:
- Review of existing literature on barriers to hypertension management.
- Analysis of challenges in drug development for novel, long-acting hypertension treatments.
- Framework development for clinical trial design, including safety, surrogate endpoints, and standard of care.
Main Results:
- Identified key barriers including clinical inertia, limited health literacy, nonadherence, and reimbursement issues.
- Highlighted the potential of RNA-targeted therapies and device interventions to overcome adherence barriers.
- Emphasized the need for specific clinical trial designs for novel long-acting treatments.
Conclusions:
- Novel therapies offer potential to overcome significant treatment barriers for hypertension.
- Careful consideration of clinical trial design is crucial for evaluating new cardiovascular risk factor treatments.
- Early and broad implementation programs are essential for translating innovations into improved patient outcomes.
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