Hypertension: The new drug helped lower blood pressure for 6 months

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Adherence to high blood pressure medication is important to reduce the risks associated with uncontrolled hypertension. A new drug being studied may lead to the development of safer drugs with longer-lasting effects. Jovana Milanko/Stocksy
  • The study drug zilebesiran was found to be safe and effective in reducing systolic blood pressure in people with mild to moderate high blood pressure for up to six months with just one injection.
  • Over 1 billion people worldwide have high blood pressure. Hypertension puts a person at greater risk of various health problems throughout the body.
  • Many people have trouble adhering to their high blood pressure medication prescriptions, leaving them open to the risks associated with uncontrolled hypertension.

Research drug so-called bewildered has been found to be safe and effective in reducing systolic blood pressure in people with mild to moderate high blood pressure for up to six months with just one injection.

These findings from a phase 2 clinical trial of the drugs were recently presented at the American Heart Association’s 2023 Scientific Sessions.

Over 1 billion people around the world have high blood pressure, medically known as hypertension.

Previous studies show that high blood pressure increases a person’s risk for several cardiovascular problems, such as stroke, heart failure, and atrial fibrillation.

In addition, people with hypertension are more likely to kidney damage, metabolic syndromedementia and vision issues.

High blood pressure is treated through medication and lifestyle changes, such as a healthy diet and increased physical activity.

However, previous research shows that not all people with high blood pressure adhere to their prescribed medications, with many discontinuation of medication after a year. This leaves them open to the risks associated with uncontrolled hypertension.

According to Dr. George L. According to Bakris, professor of medicine and director of the American Heart Association Comprehensive Hypertension Center at the University of Chicago Medicine and lead author of this study, over 70% of people with hypertension either do not take their medication or do not take it as prescribed.

Hence (we) have less than 30% of people with hypertension under control in the country, said Dr Bakris Medical news today. This is despite the fact that we have over 100 antihypertensive drugs to use.

Dr. Cheng-Han Chen, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, Calif., who was not involved in the study, agreed:

It is believed that a large percentage of patients do not take their blood pressure medication as prescribed. When patients do not fully adhere to their medication regimen, the chances that their blood pressure will not be controlled increases (), which in turn increases their risk of cardiovascular events.

The big problem is simply the large number of prescribed medications that patients have to follow, some of which need to be taken multiple times a day.

Dr. Jennifer Wong, a board-certified cardiologist and medical director of noninvasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif., told MNT that she has found that compliance with high blood pressure medications can be difficult with any which daily medications do not have an immediate tangible effect.

Uncontrolled hypertension is a major risk factor for the development of atherosclerotic disease, Dr. Wong continued. And it is often such a future event that it is difficult for many patients to take their medication regularly. Every 10 mm drop in blood pressure can significantly reduce their risk of these diseases.

Zillebesiran is an investigational RNA interference targeting agent angiotensinogen (AGT). AGT is a hormone produced mainly in the liver that helps regulate blood pressure in humans.

Zilebesiran blocks a message inside the cell that stimulates (the production of) a substance called angiotensinogen, Dr. Bakris explained. This is the substance it turns into angiotensin II (a) a powerful agent that causes narrowing of the arteries and raises blood pressure.

Angiotensin II has many purposes, but in excess it can raise blood pressure, he added. Thus, blocking its production reduces the likelihood of blood pressure increases and lowers pre-existing high blood pressures.

For this study, Dr. Bakris and his team recruited about 400 people with mild to moderate high blood pressure, defined as a systolic blood pressure of 135-160 mm Hg. All participants were untreated for high blood pressure or were on stable therapy with up to two antihypertensive drugs.

Study participants received doses of 150 mg, 300 mg, or 600 mg once every six months, a dose of 300 mg once every three months of zilebesiran, or a placebo.

After six months, researchers found that participants who received zilebesiran were significantly more likely to experience a 24-hour average reduction in systolic blood pressure of 20 mm Hg or more without needing to take additional high blood pressure medication.

Study participants taking zilebesiran were also more likely to achieve a 24-hour average systolic blood pressure measurement of 130 mm Hg or less at six months.

I was pleasantly surprised that the effect lasted for six months, but based on what I knew about the drug, I expected three months. Also, I didn’t expect the size of the drop to be as big as 14-15 mm Hg, but more like 7-8 mm Hg, which the pills deliver. But again, zilebesiran blocks the system more effectively.

Dr. George L. Bakris

After reviewing this research, Dr. Ian del Conde, cardiologist and director of vascular medicine at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida, said MNT that this is an exciting study that marks a new era in the treatment of high blood pressure.

I don’t think most doctors expected this kind of therapy just a few years ago, continued Dr. del Conde. The idea that a chronic condition that is extremely prevalent in all societies around the world and that has been clearly shown to increase the risk of premature death can be effectively and safely treated with a single injection given every six months or so is a game-changer.

[D]despite the availability of several classes of blood pressure-lowering drugs that are effective, safe, and inexpensive, there are still many patients who do not have our code for blood pressure control. Adherence or tolerance to conventional therapies is a common cause of uncontrolled blood pressure. This new treatment may change the way you treat high blood pressure in the future.

Prof. Sir Nilesh Samani, medical director of the British Heart Foundation, also reviewed the study and said MNT:

This study shows that an injection that can be given just twice a year is effective in lowering blood pressure. Further work is needed to show that it reduces heart attacks and strokes, but if it does, then this could be a game-changing new treatment for high blood pressure.

Dr. Chen said MNT that doctors currently do not have effective blood pressure medications for so long after a single dose.

This type of dosing interval gives us a tool to improve blood pressure over a longer period of time without having to rely on consistent daily medication adherence, he added.

This drug significantly lowered systolic blood pressure (by) by an average of at least 10 mm Hg, and sometimes by an average of 20 mm Hg or more, Dr. Chen continued. As the average systolic blood pressure at the start of this study was 142 mmHg, this meant that the patient’s blood pressure could be brought back to normal simply with this injection, without the help of additional blood pressure medication.

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