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Future pharmacological therapy in hypertension

Stewart, Merrill, H.; Lavie, Carl, J.; Ventura, Hector, O.

Current Opinion in Cardiology: July 2018 - Volume 33 - Issue 4 - p 408–415
doi: 10.1097/HCO.0000000000000529
HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie

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.

John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, Louisiana, USA

Correspondence to Merrill H. Stewart, MD, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121, USA. Tel: +1 504 842 3000; e-mail: merrill.stewart@ochsner.org

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