New Drugs on the Horizon for Hypertension

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Nephrology

Background:

• Despite existing treatments, many individuals with hypertension have uncontrolled blood pressure.
• There is a significant unmet need for more effective antihypertensive therapies.

Purpose of the Study:

• To review recently approved and investigational medications for hypertension.
• To highlight novel therapeutic approaches targeting different pathways in blood pressure regulation.

Main Methods:

• Review of Food and Drug Administration (FDA)-approved and clinical-stage antihypertensive medications.
• Focus on novel drug classes including endothelin receptor antagonists, aldosterone synthase inhibitors, and small interfering RNA (siRNA) therapeutics.

Main Results:

• Aprocitentan, an endothelin receptor antagonist, was FDA-approved in 2024 for uncontrolled hypertension.
• Aldosterone synthase inhibitors (baxdrostat, lorundrostat, vicadrostat) show significant blood pressure reduction in early trials.
• Zilebesiran, an siRNA targeting angiotensinogen, offers potential for infrequent dosing (every 3-6 months).

Conclusions:

• Novel antihypertensive medications offer unique mechanisms for improved blood pressure control.
• These new agents have the potential to benefit both individual patients and public health in managing hypertension.
• The development pipeline for hypertension treatments is expanding with promising new options.