Hypertension. The new drug helped lower blood pressure within 6 months

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Adherence to high blood pressure medications is important to reduce the risks associated with uncontrolled hypertension. A new drug under investigation may provide clues to creating safer drugs with longer-lasting effects. Jovana Milanko/Stokes
  • An investigational drug called zilebesiran was found to be safe and effective in reducing systolic blood pressure in people with mild to moderate high blood pressure with just one injection for up to six months.
  • More than 1 billion people worldwide have high blood pressure. Hypertension puts a person at greater risk for various health problems throughout the body.
  • Many people have trouble following their high blood pressure medication prescriptions, leaving them open to the risks associated with uncontrolled hypertension.

An investigational drug called zilebesiran It has been shown 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 drug were recently presented at the American Heart Association’s Scientific Sessions 2023.

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

Previous studies have shown that high blood pressure increases a person’s risk of a number of cardiovascular problems, such as stroke, heart failure and atrial fibrillation.

Also, people with hypertension have a higher chance kidney damage, metabolic syndromedementia and vision problems.

It is high blood pressure be treated through medications and lifestyle changes such as a healthy diet and increased physical activity.

However, previous research has shown that not all people with high blood pressure adhere to their prescribed medications, with many stop taking the medication a year later. This leaves them open to the risks associated with uncontrolled hypertension.

Dr. George L. do not take them as prescribed.

“As a result (we) have less than 30% of people with controlled hypertension in the country,” Dr. Bakris said. Medical news today. “This is when we have more than 100 antihypertensive drugs to use.”

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

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

A big problem is the large number of directly prescribed medications that patients have to follow, some of which have 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, CA, told MNT that she has found that compliance with high blood pressure medications can to be difficult. with any daily medication that does not have an immediate tangible effect.

“Uncontrolled hypertension is a major risk factor for the development of atherosclerotic disease,” continued Dr. Wong. “And often it’s such an event in the future that many patients have difficulty taking regular … medication. Every 10 mm drop in blood pressure can significantly reduce the risk of these diseases.”

Zilebesiran is an investigational RNA interference agent that targets angiotensinogen (AGT). AGT is a hormone produced primarily in the liver that helps regulate a person’s blood pressure.

“Zilebesiran blocks the message inside the cell that stimulates the production of a substance called angiotensinogen,” explained Dr. Bakris. “This is the stuff that turns angiotensin II — (a) a powerful substance which causes constriction of the arteries and raises the blood pressure.’

“Angiotensin II has many purposes, but too much can raise blood pressure,” he added. “So blocking its production reduces the likelihood of high blood pressure and will reduce pre-existing high blood pressure.”

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

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

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

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

“I was pleasantly surprised that the effect lasted six months, but from what I knew about the drug, I expected three months. Also, I didn’t expect the drop to be as strong as 14-15mmHg, but more like 7-8mmHg, which is what the pills are. But then again, zilebesiran blocks the system more effectively.”

– Dr. George L. Bakris

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

“I don’t think most doctors would have anticipated this kind of therapy a few years ago,” continued Dr. del Conde. “The idea that a chronic disease that is extremely common in all societies around the world and 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 therapy is a common cause of uncontrolled blood pressure. This new treatment could change the way high blood pressure is treated in the future.”

British Heart Foundation Medical Director Professor Sir Nilesh Samani also reviewed the research and said MNT::

“This study shows that the injection, which can be given twice a year, is effective in reducing blood pressure. Further work is needed to show that it reduces heart attacks and strokes, but if it does, 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 that long after a single dose.

“This kind of dosing interval gives us a tool to improve blood pressure over a long period of time without relying on consistent daily medication adherence,” he added.

“This drug significantly reduced systolic blood pressure (by) an average of at least 10 mm Hg, and sometimes an average of 20 mm Hg or more,” Dr. Chen continued. “Since the mean systolic blood pressure at the start of this study was 142 mm Hg, this meant that the patient’s blood pressure could be set to ‘normal’ with this injection alone, without the aid of additional blood pressure medication.”

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