RNA Injection Every 6 Months to Improve Adherence and Lower Blood Pressure in Patients With Hypertension

Schiffrin, Ernesto L.

doi:10.1001/jama.2023.26071

Cited by 1 publication

(1 citation statement)

References 19 publications

(33 reference statements)

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“…An antihypertensive delivered by injection with effects enduring to three or six months could represent a significant response to the challenge of apparent resistant hypertension and a major advance in our ability to control blood pressure and improve adherence to treatment. 110 Selective studies in patients with resistant hypertension are needed. Given the dramatic and sustained reduction in angiotensinogen, long term safety data in large numbers of patients will be critical.…”

Section: Angiotensinogen Synthesis Inhibitorsmentioning

confidence: 99%

Diagnosis and management of resistant hypertension

Schiffrin,

Fisher

2024

BMJ

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Resistant hypertension is defined as blood pressure that remains above the therapeutic goal despite concurrent use of at least three antihypertensive agents of different classes, including a diuretic, with all agents administered at maximum or maximally tolerated doses. Resistant hypertension is also diagnosed if blood pressure control requires four or more antihypertensive drugs. Assessment requires the exclusion of apparent treatment resistant hypertension, which is most often the result of non-adherence to treatment. Resistant hypertension is associated with major cardiovascular events in the short and long term, including heart failure, ischemic heart disease, stroke, and renal failure. Guidelines from several professional organizations recommend lifestyle modification and antihypertensive drugs. Medications typically include an angiotensin converting enzyme inhibitor or angiotensin receptor blocker, a calcium channel blocker, and a long acting thiazide-type/like diuretic; if a fourth drug is needed, evidence supports addition of a mineralocorticoid receptor antagonist. After a long pause since 2007 when the last antihypertensive class was approved, several novel agents are now under active development. Some of these may provide potent blood pressure lowering in broad groups of patients, such as aldosterone synthase inhibitors and dual endothelin receptor antagonists, whereas others may provide benefit by allowing treatment of resistant hypertension in special populations, such as non-steroidal mineralocorticoid receptor antagonists in patients with chronic kidney disease. Several device based approaches have been tested, with renal denervation being the best supported and only approved interventional device treatment for resistant hypertension.

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Section: Angiotensinogen Synthesis Inhibitorsmentioning

confidence: 99%