This Lancet review described new drug therapies for hypertension targeting novel physiological pathways including aldosterone synthase inhibition, endothelin antagonism, and RNA interference-based angiotensinogen silencing, addressing the unmet need for patients with resistant blood pressure.
Despite the availability of effective antihypertensive therapies, global blood pressure control rates remain unacceptably low. Contributing factors, such as low treatment adherence, therapeutic inertia, and rising multimorbidity, underscore the need for innovative approaches to improve hypertension care. New antihypertensive drug therapies that act on physiological pathways beyond those targeted by conventional drug classes are emerging. These therapies include small interfering RNA agents that inhibit angiotensinogen synthesis as a novel approach to inhibit the renin–angiotensin system, and new strategies to more selectively modulate aldosterone, such as aldosterone synthase inhibitors and non-steroidal mineralocorticoid receptor antagonists.
