Novel therapies for hypertension treatment

Author(s): Professor. George L. Bakris

Control rates for hypertension continue to decline due to poor medication adherence by patients despite over 120 different antihypertensive medications. Hence, cardiovascular outcomes have been worsening in the United States. Despite the plethora of antihypertensive medications available, the prevalence of resistant hypertension is estimated to be 13.7%. Single-pill combinations are highly effective in improving medication adherence rates as seen in various studies. Four relatively novel classes of promising medications and two procedural interventions are being developed to expand our treatment arsenal for patients with resistant hypertension. This article presents a short overview of these medications and procedures most in the early stages of development. These new pharmacological agents are also from novel classes of medications including non-steroidal mineralocorticoid receptor antagonists, dual endothelin receptor antagonists, aldosterone synthetase inhibitors, a mutant atrial natriuretic peptide, and an RNA interference as well as a knockout molecule of hepatic angiotensinogen. Additionally, an update on renal denervation is presented. Based on the available data and assuming no new issues with safety develop, it will be at least 12-18 months for any of these new pharmacological agents to get approved.

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