Why the study?
Improving drug therapy effectiveness and reducing adverse cardiovascular and renal outcomes in resistant hypertension remains an unsolved problem, as existing medications do not achieve target blood pressure in many patients.
Do new pharmacological approaches (SGLT2 inhibitors, brain aminopeptidase A inhibitors, endothelin receptor antagonists) improve blood pressure control in patients with resistant hypertension?
Do new pharmacological approaches (SGLT2 inhibitors, brain aminopeptidase A inhibitors, endothelin receptor antagonists) improve blood pressure control in patients with resistant hypertension?
This review highlights emerging pharmacological therapies, such as SGLT2 inhibitors and endothelin receptor antagonists, for managing resistant hypertension when standard therapies like spironolactone are insufficient.
May support trial design for resistant hypertension; leaves open clinical adoption pending randomized data.
Improving the effectiveness of drug therapy and reducing the risk of adverse cardiovascular and renal outcomes in patients with resistant hypertension (HTN) remains an unsolved problem of cardiology. The results of the PATHWAY-2, PATHWAY-3 and ReHOT studies have shown the clinical efficacy of spironolactone, amiloride and, to a lesser extent, the antiadrenergic drugs clonidine, bisoprolol and doxazosin in improving blood pressure (BP) control in this patient population. However, the inclusion of spironolactone and other known drugs in antihypertensive therapy does not ensure the achievement of target BP level in a significant proportion of these patients. The review presents the results of clinical studies of new approaches aimed at increasing the effectiveness of drug therapy in resistant HTN including sodium-glucose cotransporter type 2 inhibitors, brain aminopeptidase A inhibitors, and new antagonists of endothelin receptors.
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Ob et al. (2021) studied this question.
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