In this review, researchers summarized the new developments in anti-hypertensive treatments.

Hypertension (high blood pressure) is a factor associated with the development of heart disease and organ damage. In most cases hypertension is very easily controlled. In about 10-15% of cases, however, patients do not respond to treatment (resistant hypertension). Novel treatments are required for these patients. Other patients do not continue taking their medications due to unwanted side effects.

The needs of patients with resistant hypertension or unwanted side effects must be met. Therefore, new treatments for hypertension are continually being researched. 

The current study reviewed new developments in the treatment of hypertension.

High levels of sodium (salt) are associated with hypertension. Treatments such as spironolactone (Aldactone) reduce the amount of sodium that is reabsorbed through the kidneys. These treatments have been associated with increased potassium levels, which can be dangerous, particularly in patients with kidney disease. Finerenone is a new treatment being developed which can decrease sodium without increasing potassium. Trials in patients with heart failure and mild kidney disease showed finerenone to be as effective as spironolactone without increased risk of kidney problems.

Treatments such as valsartan (Diovan) relax the blood vessels, allowing for easier blood flow. LCZ696 (also known as Entresto) is a new treatment that combines valsartan and another treatment to further decrease blood pressure. One study of 1328 patients with mild hypertension compared LCZ696 to valsartan. LCZ696 treatment led to a significantly larger decrease in blood pressure than valsartan. A second study compared LCZ696 to enalapril (another common hypertension treatment) in patients with heart failure. LCZ696 led to a 20% reduction in death due to heart problems and a 16% increased survival rate. The treatment also led to a 21% decrease in the number of patients needing hospitalization. The trial was stopped early because of the obvious benefits of LCZ696 treatment in comparison to enalapril.

Vaccination is being examined as a possible treatment for hypertension. A vaccine (AngQb) that targets a hormone that constricts blood vessels significantly reduced blood pressure compared to a placebo (substance with no effect on the body). Further studies are needed to fully understand the safety and effectiveness of vaccines for hypertension.

Renal denervation is a procedure that damages certain nerves leading out of the kidneys. This decreases the production of a hormone that can increase blood pressure. Results of studies on renal denervation have been mixed, with some showing no benefit. Recent studies have found renal denervation to be at least as effective as drug treatments at lowering blood pressure, with fewer side effects.

A newer treatment targets the baroreflex, one of the body’s natural mechanisms for regulating blood pressure. An implanted device that stimulates this reflex has been shown in early studies to lower blood pressure.

This review examined the new possibilities in hypertension treatment, but also highlighted the areas which require more research.

All of the methods mentioned above are still under development and are not yet ready for use in the general public.