Key result
Novel antihypertensives across 9 classes show favorable BP lowering and minimal adverse effects vs conventional therapy.
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Cardiovascular disease stands as the leading cause of death globally, with hypertension emerging as an independent risk factor for its development. The worldwide prevalence of hypertension hovers around 30%, encompassing a staggering 1.2 billion patients, and continues to escalate annually. Medication plays a pivotal role in managing hypertension, not only effectively regulating blood pressure (BP) but also substantially mitigating the occurrence of cardiovascular and cerebrovascular diseases. This review comprehensively outlines the categories, mechanisms, clinical applications, and drawbacks of conventional antihypertensive drugs. It delves into the five primary pharmacological classifications, namely β-receptor blockers, calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), and diuretics. The emphasis is placed on elucidating the mechanisms, advantages, and research progress of novel antihypertensive drugs targeting emerging areas. These include mineralocorticoid receptor antagonists (MRAs), atrial natriuretic peptides (ANPs), neutral endopeptidase inhibitors (NEPIs), sodium-dependent glucose transporter 2 inhibitors (SGLT-2Is), glucagon-like peptide-1 receptor agonists (GLP-1RAs), endothelin receptor antagonists (ERAs), soluble guanylate cyclase (sGC) agonists, brain aminopeptidase A inhibitors (APAIs), and small interfering ribonucleic acids (siRNAs) targeting hepatic angiotensinogen. Compared to conventional antihypertensive drugs, these novel alternatives exhibit favorable antihypertensive effects with minimal adverse reactions. This review serves as a valuable reference for future research and the clinical application of antihypertensive drugs.
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Huang et al. (2024) conducted a review in Hypertension. Novel antihypertensive drugs (MRAs, ANPs, NEPIs, SGLT-2Is, GLP-1RAs, ERAs, sGC agonists, APAIs, hepatic angiotensinogen siRNAs) vs. Conventional antihypertensive drugs (β-blockers, CCBs, ACEIs, ARBs, diuretics) was evaluated. Novel antihypertensive drugs across 9 classes exhibit favorable blood pressure-lowering effects with minimal adverse reactions compared to 5 conventional classes for ~1.2 billion hypertension patients.
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