Future pharmacological therapy in hypertension

Curr Opin Cardiol. 2018 Jul;33(4):408-415. doi: 10.1097/HCO.0000000000000529.


Purpose of review: Hypertension (HTN) is a widespread and growing disease, with medication intolerance and side-effect present among many. To address these obstacles novel pharmacotherapy is an active area of drug development. This review seeks to explore future drug therapy for HTN in the preclinical and clinical arenas.

Recent findings: The future of pharmacological therapy in HTN consists of revisiting old pathways to find new targets and exploring wholly new approaches to provide additional avenues of treatment. In this review, we discuss the current status of the most recent drug therapy in HTN. New developments in well trod areas include novel mineralocorticoid antagonists, aldosterone synthase inhibitors, aminopeptidase-A inhibitors, natriuretic peptide receptor agonists, or the counter-regulatory angiotensin converting enzyme 2/angiotensin (Ang) (1-7)/Mas receptor axis. Neprilysin inhibitors popularized for heart failure may also still hold HTN potential. Finally, we examine unique systems in development never before used in HTN such as Na/H exchange inhibitors, vasoactive intestinal peptide agonists, and dopamine beta hydroxylase inhibitors.

Summary: A concise review of future directions of HTN pharmacotherapy.

Publication types

  • Review

MeSH terms

  • Antihypertensive Agents / pharmacology*
  • Antihypertensive Agents / therapeutic use*
  • Cytochrome P-450 CYP11B2 / antagonists & inhibitors
  • Dopamine beta-Hydroxylase / antagonists & inhibitors
  • Glutamyl Aminopeptidase / antagonists & inhibitors
  • Humans
  • Hypertension / drug therapy*
  • Mineralocorticoid Receptor Antagonists / therapeutic use
  • Neprilysin / antagonists & inhibitors
  • Receptors, Atrial Natriuretic Factor / agonists
  • Receptors, Vasoactive Intestinal Peptide / agonists
  • Renin-Angiotensin System / drug effects
  • Sodium-Hydrogen Exchanger 3 / antagonists & inhibitors


  • Antihypertensive Agents
  • Mineralocorticoid Receptor Antagonists
  • Receptors, Vasoactive Intestinal Peptide
  • Sodium-Hydrogen Exchanger 3
  • Cytochrome P-450 CYP11B2
  • Dopamine beta-Hydroxylase
  • Glutamyl Aminopeptidase
  • Neprilysin
  • Receptors, Atrial Natriuretic Factor