Cited by 277Blood Pressure and Hypertension StudiesRenin-Angiotensin System StudiesHormonal Regulation and Hypertension

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New Approaches in the Treatment of Hypertension

Oparil, Suzanne, Schmieder, Roland E.·2015·Circulation Research

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Abstract

Hypertension is the most common modifiable risk factor for cardiovascular disease and death, and lowering blood pressure with antihypertensive drugs reduces target organ damage and prevents cardiovascular disease outcomes. Despite a plethora of available treatment options, a substantial portion of the hypertensive population has uncontrolled blood pressure. The unmet need of controlling blood pressure in this population may be addressed, in part, by developing new drugs and devices/procedures to treat hypertension and its comorbidities. In this Compendium Review, we discuss new drugs and interventional treatments that are undergoing preclinical or clinical testing for hypertension treatment. New drug classes, eg, inhibitors of vasopeptidases, aldosterone synthase and soluble epoxide hydrolase, agonists of natriuretic peptide A and vasoactive intestinal peptide receptor 2, and a novel mineralocorticoid receptor antagonist are in phase II/III of development, while inhibitors of aminopeptidase A, dopamine β-hydroxylase, and the intestinal Na(+)/H(+) exchanger 3, agonists of components of the angiotensin-converting enzyme 2/angiotensin(1-7)/Mas receptor axis and vaccines directed toward angiotensin II and its type 1 receptor are in phase I or preclinical development. The two main interventional approaches, transcatheter renal denervation and baroreflex activation therapy, are used in clinical practice for severe treatment resistant hypertension in some countries. Renal denervation is also being evaluated for treatment of various comorbidities, eg, chronic heart failure, cardiac arrhythmias and chronic renal failure. Novel interventional approaches in early development include carotid body ablation and arteriovenous fistula placement. Importantly, none of these novel drug or device treatments has been shown to prevent cardiovascular disease outcomes or death in hypertensive patients.

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Authors: Oparil, S., & Schmieder, R. E.
Affiliations: University of Alabama at Birmingham Hospital (US)
ORCID: Oparil, Suzanne
Schmieder, Roland E.
Venue: Circulation Research
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2015-03-13
Volume: 116
Issue: 6
Pages: 1074-1095
ISSN: 0009-7330 (ISSN-L)
1524-4571
DOI: 10.1161/circresaha.116.303603
OpenAlex: W2138173257
Cited by: 276
References: 213
Citations by year: 2026: 10 · 2025: 14 · 2024: 20 · 2023: 26 · 2022: 23 · 2021: 27 · 2020: 30 · 2019: 33 · 2018: 26 · 2017: 29 · 2016: 24 · 2015: 14
FWCI: 22.79
Type: journal article
Language: en
Open access: closed
Locations: Circulation Research (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords: hypertension, antihypertensive drugs, treatment-resistant hypertension, vasopeptidase inhibitors, aldosterone synthase inhibitors, soluble epoxide hydrolase inhibitors, mineralocorticoid receptor antagonists, dopamine beta-hydroxylase inhibitor, Na+/H+ exchanger 3, baroreflex activation therapy, arteriovenous fistula, cardiovascular disease prevention, uncontrolled hypertension
MeSH terms: Mineralocorticoid Receptor Antagonists, Animals, Antihypertensive Agents, Arteriovenous Shunt, Surgical, Carotid Body, Clinical Trials as Topic, Electric Stimulation Therapy, Enzyme Inhibitors, Female, Humans, Hypertension, Ion Channels, Kidney, Kidney Tubules, Pre-Eclampsia, Pregnancy, Pressoreceptors, Receptors, Cell Surface, Renal Artery, Renin-Angiotensin System, Sympathectomy, Sympathetic Nervous System, Drug Design, Multicenter Studies as Topic, Drugs, Investigational, Stents, Comorbidity, Randomized Controlled Trials as Topic, Baroreflex, Oxidative Stress, Decompression, Surgical, Models, Animal, Therapies, Investigational, High-Intensity Focused Ultrasound Ablation, Molecular Targeted Therapy

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