Novel pharmacological approaches to lowering blood pressure and managing hypertension

Hypertension is the leading cause of death globally, primarily due to its strong association with cardiovascular disease. Its prevalence has surged over the past three decades, driven by rising rates of diabetes mellitus and obesity. Despite current antihypertensive therapies, only a small proportion of patients with hypertension achieve adequate blood pressure control, necessitating novel therapeutic strategies. This Review explores the current challenges and emerging opportunities in hypertension management. The dual endothelin-receptor antagonist, aprocitentan, the first agent to be licensed from a new antihypertensive class since 2007, exemplifies innovative treatments on the horizon. The Review also addresses the complex factors contributing to poor hypertension control, including genetic influences, lifestyle factors, therapeutic inertia, and patient adherence issues. We discuss the limitations of existing therapies and highlight promising new pharmacological approaches to hypertension management. Integrating these novel treatments alongside current pharmaceuticals combined with improved diagnostic and management strategies could significantly reduce the global burden of hypertension and associated cardiovascular disease.