The NEW-HOPE study and emerging therapies for difficult-to-control and resistant hypertension

Prog Cardiovasc Dis. Jan-Feb 2020;63(1):64-73. doi: 10.1016/j.pcad.2019.12.008. Epub 2020 Jan 8.

Abstract

Despite the availability of numerous approved antihypertensive drugs, difficult-to-control and resistant hypertension are persistent and are major risk factors for cardiovascular disease. Emerging and investigational treatments that are currently being explored to target hypertension include firibrastat, empagliflozin and interventional procedures, including improved approaches to renal artery denervation and a novel baroreceptor device implantation. Firibrastat is an investigational drug that specifically and selectively inhibits aminopeptidase A leading to decreased formation of angiotensin III in the brain, resulting in decreased blood pressure. Sodium-glucose cotransporter-2 inhibitors, such as empagliflozin used to treat type 2 diabetes, may be beneficial as antihypertensive agents. Empagliflozin in a recent study demonstrated significant reductions in high blood pressure in an African American population. Advances in renal artery denervation and an investigational baroreceptor device implantation also show promise as potential interventions in patients with difficult-to-control and resistant hypertension.

Trial registration: ClinicalTrials.gov NCT03198793 NCT02182830.

Keywords: Ambulatory blood pressure monitoring; Automated office blood pressure; Baroreceptor device; Blood pressure; Difficult-to-control hypertension; Empagliflozin; Firibrastat; Hypertension; Interventional approaches; Masked hypertension; Renal artery denervation; Resistant hypertension; SGLT-2 inhibitors; White-coat hypertension.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / therapeutic use*
  • Baroreflex
  • Blood Pressure / drug effects*
  • Drug Resistance*
  • Drug Therapy, Combination
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Hypertension / therapy*
  • Implantable Neurostimulators*
  • Prosthesis Implantation / adverse effects
  • Prosthesis Implantation / instrumentation*
  • Risk Factors
  • Sympathectomy* / adverse effects
  • Treatment Outcome

Substances

  • Antihypertensive Agents

Associated data

  • ClinicalTrials.gov/NCT03198793
  • ClinicalTrials.gov/NCT02182830