Latest news with #hypertension
Medical News Today
2 days ago
- Business
- Medical News Today
Hypertension: New drug shows strong results in managing blood pressure
A clinical trial has seen promising results from a new class of medication to treat hypertension. Design by MNT; Photography by Peca King/500px/Getty Images & MementoJpeg/Getty Images A novel treatment for hard-to-control high blood pressure has shown strong results in a major global clinical trial. The Phase 3 Launch-HTN study found that lorundrostat, an aldosterone synthase inhibitor, safely and consistently lowered blood pressure in a large, diverse group of patients who had not responded to other medications. These findings mark a significant step forward in the development of the first targeted aldosterone synthase inhibitor for these conditions. Blood pressure refers to the force exerted by blood against the walls of the arteries. Hypertension, or high blood pressure, happens when this force is consistently higher than normal. Hypertension impacts one in three adults globally and significantly raises the risk of heart disease, heart attacks, and strokes. Resistant hypertension is a form of high blood pressure that remains elevated despite a person taking three different blood pressure medications at their maximum recommended doses. Up to 15% of individuals with hypertension have abnormal regulation of aldosterone, a hormone that helps control blood pressure. When aldosterone levels are elevated due to this dysregulation, it can lead to hypertension. A new study, presented at the 34th European Meeting on Hypertension and Cardiovascular Protection, shows that lorundrostat — a drug that inhibits aldosterone synthase — is both safe and effective for treating individuals with uncontrolled or resistant hypertension. The findings are yet to be published in a peer-reviewed journal. Lorundrostat is specifically designed to lower aldosterone levels by targeting and inhibiting CYP11B2, the enzyme that drives its production. The study demonstrated consistent reductions in blood pressure across a large and diverse group of patients and represents the largest phase three trial to date for this class of treatment. Manish Saxena, MD, Clinical Co-Director of the William Harvey Heart Centre at Queen Mary University of London and Hypertension Specialist from Barts Health NHS Trust and the study's lead Investigator, spoke to Medical News Today . 'Despite available treatments, more than 40% of adults with hypertension worldwide are not reaching their blood pressure goal. Aldosterone pathway plays important role in blood pressure regulation, and leads to blood pressure related complications such as heart failure and kidney problems. In the Launch-HTN trial we explored the safety and effectiveness of lorundostat, which belongs to a new class of drugs called aldosterone synthase inhibitors that block production of hormone aldosterone from the adrenal glands.' — Manish Saxena, MD 'The Launch-HTN trial is the largest phase 3 hypertension study with a novel drug,' Saxena explained. 'We tested lorundostat in a large, diverse patient population recruited globally and found that it has good safety profile and lowered blood pressure consistently in all of our patient groups.' How lorundrostat works 'Hormone aldosterone secreted from adrenal glands in the body plays an important role in driving blood pressure. Now there is more awareness of dysregulated aldosterone secretion in patients with difficult to treat blood pressure. Lorundrostat blocks biosynthesis of hormone aldosterone in the body and helps reduce blood pressure.' — Manish Saxena, MD The Launch-HTN trial was a global, Phase 3 study that was randomized, double-blind, and placebo-controlled. It included adult participants whose blood pressure remained uncontrolled despite taking two to five antihypertensive medications. Designed to reflect real-world clinical practice, the trial used automated office blood pressure (AOBP) measurements and allowed participants to continue their existing treatments. Lorundrostat, administered once daily at a 50 mg dose, showed meaningful and sustained reductions in systolic blood pressure — dropping by 16.9 mmHg at Week 6 (a 9.1 mmHg reduction compared to placebo) and by 19 mmHg at Week 12 (an 11.7 mmHg reduction versus placebo). 'The LAUNCH-HTN trial demonstrated blood pressure lowering efficacy and safety of lorundrostat in a very diverse patient group with uncontrolled and difficult to treat hypertension that were on background 2-5 blood pressure lowering medication. The blood pressure reduction observed was consistent across key sub-groups, significant and clinically meaningful.' — Manish Saxena, MD Two experts, not involved in the study, also spoke to MNT . Cheng-Han Chen, MD, board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, noted that 'aldosterone synthase inhibitors are a new class of drugs being studied for the treatment of hypertension.' 'This trial found that lorundrostat, one of these new types of drugs, was safe and effective for patients with uncontrolled or resistant hypertension. This puts us one step closer to having another tool in our arsenal for patients with difficult to control blood pressure despite being on multiple medications,' Chen explained. 'Many patients have high blood pressure that are not under control with multiple classes of medications. By having another class of blood pressure medications at our disposal, we will better be able to reduce rates of hypertension in our population and improve health outcomes.' — Cheng-Han Chen, MD Rigved Tadwalkar, MD, FACC, consultative cardiologist and director of Digital Transformation Pacific Heart Institute in Santa Monica, CA told MNT that 'this is a meaningful step forward.' 'We still see far too many patients with uncontrolled or resistant hypertension, even when they're on three, four, sometimes five medications. The reality is that for a significant subset of these patients, aldosterone is driving the problem and until now, we haven't had a way to target that mechanism directly in a safe, practical way,' Tadwalkar explained. 'Lorundrostat appears to change that. It inhibits aldosterone synthesis at the enzymatic level, and based on this trial, it does so with a good safety profile and consistent efficacy across a diverse population. The blood pressure reductions– nearly 17 mmHg at 6 weeks and close to 19 mmHg at 12– are significant, especially when you consider that these were already heavily treated patients. That kind of additional drop is not something we usually see at this stage of therapy.' — Rigved Tadwalkar, MD, FACC 'Since patients stayed on their background medications, these results feel more clinically relevant than more tightly controlled washout studies,' Tadwalkar added. 'It's a welcome addition to the field, even as we continue to see the limitations of existing therapies, including newer device-based approaches like renal denervation.' Tadwalkar said that lorundrostat had potential to make a real difference in patients' lives. 'If lorundrostat becomes widely available, it could offer a new option for patients who've exhausted standard pathways. For people living with resistant hypertension, many of whom are already dealing with co-morbidities like kidney disease or heart failure, having another tool, especially one that targets the underlying hormonal dysregulation, could make a real difference in long-term outcomes,' he said. Saxena said that once lorundostat becomes commercially available, it could become a novel treatment option for hypertension for many patients. Tadwalkar continued by noting that 'at the population level, we're still facing a huge burden from poorly controlled blood pressure.' He said untreated hypertension was a major contributor to chronic diseases and cardiovascular problems. 'A drug like this, if used properly, could help narrow that treatment gap. It's certainly not a silver bullet, but it's a step toward more personalized, mechanism-specific care. This is something the hypertension field has needed for a long time.' — Rigved Tadwalkar, MD, FACC Hypertension Clinical Trials / Drug Trials Drugs
Medscape
6 days ago
- General
- Medscape
Rapid Rx Quiz: Calcium-Channel Blockers
Calcium-channel blockers (CCBs) play a central role in the treatment of hypertension, angina, and certain cardiac arrhythmias and are among the most commonly prescribed drugs in the United States. Beyond their US Food and Drug Administration–approved uses, CCBs have found a place in treating several off-label conditions. With their widespread use, however, comes the responsibility of understanding their pharmacodynamics, drug-drug interactions, and potential toxicities. How much do you know about CCBs? Test yourself with this short quiz. Off-label uses for CCBs include Raynaud phenomenon, migraines, and subarachnoid hemorrhage. CCBs do not treat depression; in fact, their use has been associated with depression. Verapamil might reduce diastolic dysfunction, but this is not a mainstream use. The most common CCBs are relatively weight neutral. Learn more about Raynaud phenomenon. Including lightheadedness, specific adverse and serious adverse events from CCB use are bradycardia, constipation, headaches, flushing, worsening cardiac output, and peripheral edema, possibly from fluid redistributing from the intravascular space. Learn more about dizziness and vertigo. A recent study found that amlodipine was involved in the majority of overdose cases, accounting for 62% of all CCB overdoses. This far surpasses other agents such as lercanidipine (12%), diltiazem (11%), verapamil (10%), and felodipine (5%). The lower incidence of overdoses involving lercanidipine, diltiazem, verapamil, and felodipine corresponds with their declining presence in current hypertension treatment guidelines. Although amlodipine is involved in more overdose cases overall, the study underscores that the severity of overdose varies significantly by CCB class. Nondihydropyridines, such as diltiazem and verapamil, were associated with markedly higher rates of life-threatening complications, including dysrhythmias (33-35% of cases) and intensive care unit (ICU) admissions (52% and 30%, respectively). In contrast, amlodipine showed much lower rates of dysrhythmias (1%) and ICU admissions (18%). Learn more about CCB toxicity. Many of the signs and symptoms of CCB toxicity are similar to normal CCB adverse events, making diagnosis challenging. A blood test can aid in diagnosis; abnormal findings that suggest CCB toxicity include acidosis, hyperglycemia, and hypokalemia. Neutrophilia has no established connection. Learn more about CCB toxicity. Combining diltiazem or verapamil with direct oral anticoagulants might increase risk for bleeding or clotting complications, though previous research has shown mixed results. A recent study found no evidence of increased risk when direct oral anticoagulants were used alongside diltiazem or verapamil. However, patients who began direct oral anticoagulant therapy while already taking diltiazem had higher rates of overall mortality and cardiovascular-related death within 30 days, compared with those taking anticoagulants alone. Learn more about diltiazem.
Medscape
7 days ago
- Business
- Medscape
Canada Targets PCPs With New Hypertension Guideline
Hypertension Canada has released a guideline that aims to enhance the standard of hypertension management in primary care settings with evidence-based, pragmatic, and easy-to-implement recommendations. The guidance is based on the World Health Organization's HEARTS framework to improve hypertension control and reduce cardiovascular burden. The previous guideline was published in 2020. 'For the 2025 guideline, a new approach was selected in view of the declining rates of hypertension control in Canada,' guideline committee co-chairs Rémi Goupil, MD, University of Montreal, and Gregory Hundemer, MD, McGill University, both in Montreal, told Medscape Medical News . 'The first step is this Primary Care Hypertension Canada guideline, which is tailored specifically to primary care providers, who manage 90% of people with hypertension.' Gregory Hundemer, MD The guideline, published online in the Canadian Medical Association Journal, was designed from inception with primary care in mind, and most members of the writing committee were primary care providers, they said. The target users are family physicians, nurse practitioners, nurses, and pharmacists, as well as policymakers and patients and caregivers affected by hypertension. 'The guideline provides pragmatic diagnostic and treatment algorithms, listing specific drugs, their dosage, and the sequence in which they should be prescribed,' they added. 'Patient voices were included in all steps of the process, and a patient-specific guideline is published alongside the primary care guideline.' Rémi Goupil, MD Key Recommendations The guideline committee made nine recommendations covering hypertension diagnosis and treatment. The most important recommendations , according to Goupil and Hundemer, are: 1. Defining hypertension as a blood pressure (BP) ≥ 130/80 mm Hg, provided it is confirmed with an out-of-office BP assessment. 'Lowering of the hypertension diagnosis threshold will significantly increase the number of people labeled with hypertension in Canada, although only a small fraction is expected to require pharmacotherapy initiation,' they said. 'This new threshold reflects the growing evidence regarding the cardiovascular risk reduction associated with lower blood pressure levels.' All adults with hypertension should initiate treatment (healthy lifestyle changes with or without pharmacotherapy) to target a systolic BP < 130 mm Hg. Start with low-dose combination therapy (ideally as a single pill combination) when pharmacotherapy initiation is needed. Specifically, this includes drugs from two of the following three complementary classes of medications: Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), thiazide or thiazide-like diuretics, and long–acting dihydropyridine calcium channel blockers (CCBs). Other recommendations include: Healthy lifestyle changes for all adults with hypertension. Pharmacotherapy initiation for hypertension for adults with BP ≥ 140/90 mm Hg and for adults with systolic BP 130-139 mm Hg at high cardiovascular disease risk. If BP remains above the target despite the recommended two-drug combination therapy, three-drug combination therapy consisting of an ACEI or ARB, a thiazide or thiazide-like diuretic, and a long–acting dihydropyridine CCB is recommended. If BP remains above target despite three-drug combination therapy at maximally tolerated doses, the addition of spironolactone is recommended. 'This guideline is only the first step in Hypertension Canada's approach,' Goupil and Hundemer said. 'The next step is the comprehensive guideline, in which specific topics will be evaluated in-depth to provide recommendations for more specific situations, such as the optimal management of hypertension in diabetes or in resistant hypertension.' The comprehensive guideline is expected in 2026. HEARTS to Boost Implementation Canadian Cardiovascular Society spokesperson Sheldon Tobe, MD, professor of medicine at the University of Toronto and Northern Ontario School of Medicine, Toronto, commented on the guideline for Medscape Medical News . Sheldon Tobe, MD 'We have evidence that Canada's position of best blood pressure awareness, treatment, and control in the world has been slipping, and that was before the pandemic,' he said. 'One of the reasons is loss of support for dissemination and implementation by the Public Health Agency of Canada more than a decade ago. The promotion of the HEARTS framework will help to bring policymakers into the implementation of blood pressure control again. The simplified approach to one BP target will facilitate dissemination efforts as well.' A concern, however, is the small number of people involved in creating the guideline. 'In the past, a very large part of the hypertension community was involved, which ensured that there was widespread agreement with the process and results,' said Tobe, who was not involved in developing the guideline. 'This included the interprofessional community of nurses and dietitians, in addition to pharmacists and doctors. If the HEARTS framework is formally adopted by Canada, this will be very helpful.' Regarding specific recommendations, he said, 'The guideline has suggested that the preferred initial combination therapy will be irbesartan and hydrochlorothiazide, including splitting the pill, which strays off-label. This might be off-putting to some Canadians who don't realize that almost all of our antihypertensives are now generic and are fairly inexpensive.' Furthermore, he said, 'I was disappointed that the issue of drug shortages, which have greatly impacted blood pressure management in Canada recently, was not mentioned in more detail. There does not seem to be any focus by policymakers on a sustainable supply for these lifesaving medications.' The funding for this initiative was provided by Hypertension Canada. Goupil reported receiving research grants from the Canadian Institutes of Health Research (CIHR), the Kidney Foundation of Canada, Fonds de recherche du Québec — Santé, and Université de Montréal, as well as holding unpaid positions as a board member of the Canadian Society of Nephrology and vice president of the Société québécoise d'hypertension artérielle. Hundemer reported receiving research grants from the CIHR, the Kidney Foundation of Canada, and The Ottawa Hospital Academic Medical Organization, and is the Lorna Jocelyn Wood Chair for Kidney Research at The Ottawa Hospital Research Institute. Tobe reported receiving honoraria for lectures and payments to support accredited continuing medical education programs from AstraZeneca, Bayer, Boehringer Ingelheim, CHEP+, Eisai, GSK, Janssen Pharmaceuticals, KMH, Novo Nordisk, and Otsuka. He also reported participation in a living kidney donor safety study sponsored by the CIHR, serving as a volunteer board member for the American Hypertension Specialist Certification Program, a volunteer co-chair for C-Change, and serving as physician organization chair of the implementation arm of C-Change for CHEP+.
Medscape
7 days ago
- Business
- Medscape
Concurrent Hypertension and T2D Raises Risk for Mortality
The prevalence of concurrent hypertension and type 2 diabetes (T2D) doubled from approximately 6% to 12% in the United States between 1999 and 2018, with the coexistence of these conditions being associated with a notable increase in the risk for all-cause and cardiovascular mortality. METHODOLOGY: Hypertension and T2D are major contributors to morbidity and cardiovascular mortality, both in the United States and globally. Quantifying how each condition, alone or in combination, affects the risk for mortality is essential to guide interventions that reduce chronic disease burden and improve quality of life. Researchers analyzed data from 48,727 adults (mean age, 47.4 years; 51.8% women) in the 1999-2018 National Health and Nutrition Examination Survey to investigate the associations of concurrent hypertension and T2D with the risk for mortality. Participants were categorized into four groups: No hypertension and no T2D (50.5%), hypertension only (38.4%), T2D only (2.4%), and coexisting hypertension and T2D (8.7%); sociodemographic and clinical characteristic data were obtained through interview questionnaires. Participants were followed up for a median duration of 9.2 years, and the outcomes analyzed were all-cause and cardiovascular mortality. TAKEAWAY: During the follow-up period, 7734 deaths occurred, including 2013 cardiovascular deaths. Compared with having neither condition, having concurrent hypertension and T2D predicted a higher risk for both all-cause mortality (hazard ratio [HR], 2.46; 95% CI, 2.45-2.47) and cardiovascular mortality (HR, 2.97; 95% CI, 2.94-3.00), with stronger associations in women than in men ( P for interaction < .01). for interaction < .01). Compared with having hypertension or T2D only, having concurrent hypertension and T2D predicted an up to 66% higher risk for all-cause mortality and a more than twofold higher risk for cardiovascular mortality. Having concurrent prediabetes and elevated blood pressure was associated with an up to 19% higher risk for mortality than having neither condition or having just one of the conditions, indicating that the risk for mortality can begin increasing even before developing T2D or hypertension. IN PRACTICE: 'Given the growing aging population in the US and globally and the associated projected chronic disease burden, our findings underscore the critical need for public health policy and interventions that prevent and address multiple cardiometabolic morbidities to mitigate their downstream impact on further morbidity, extend the lifespan, and preserve quality of life,' the authors wrote. SOURCE: This study was led by Ye Yuan, Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York City. It was published online on May 21, 2025, in Diabetes Care . LIMITATIONS: This study was limited by the lack of longitudinal data on changes in hypertension and T2D status, control, and medication use throughout the follow-up period, hindering the ability to assess how these changes affected the risk for mortality over time. Additionally, the reliance on self-reported data for hypertension and T2D medication use, as well as other covariates such as alcohol use and smoking, may have introduced measurement error. DISCLOSURES: Some authors reported receiving grants from the National Heart, Lung, and Blood Institute; American Heart Association; National Institute on Minority Health and Health Disparities; and other sources. The authors reported having no conflicts of interest.
Daily Mail
25-05-2025
- Health
- Daily Mail
EXCLUSIVE Mystery explosion of high blood pressure in under-50s revealed: It causes catastrophic damage and millions are at risk. Now top doctors expose the foods and common habits that are turning deadly
A decade ago health chiefs launched a bold national drive with a simple message: tackle high blood pressure, cut deaths – and save the NHS billions. The need was urgent. Hypertension, as it is known medically, affects a third of adults and dramatically raises the risk of heart attacks, strokes, kidney failure and even dementia.
