New ways to lower blood pressure and treat hypertension

New ways to lower blood pressure and treat hypertension

Introduction

High blood pressure, or hypertension, is one of the biggest causes of heart disease and early death across the world. Despite many medicines being available, most people with hypertension don’t get it under control. This has pushed scientists to look for newer and better ways to manage it—and the good news is, they’re finding them.

Why Blood Pressure Matters

High blood pressure doesn’t usually show symptoms, but it quietly damages the heart, blood vessels, kidneys, and even the brain. Treating it well can prevent heart attacks, strokes, and kidney failure. But the truth is, many people don’t even know they have hypertension, and even among those who do, very few manage to keep their blood pressure at healthy levels.

What’s Going Wrong?

There are several reasons why blood pressure often stays uncontrolled. These include not knowing you have it, skipping medications, side effects from drugs, or doctors not changing medicines when needed. Lifestyle issues like too much salt, not enough exercise, and stress also play a role.

New Drugs on the Horizon

For decades, most blood pressure medicines worked through the same few pathways. Now, that’s changing. The U.S. FDA recently approved aprocitentan, a new type of drug that works by blocking certain molecules called endothelins that tighten blood vessels. This is the first such approval in nearly 20 years, offering fresh hope for people with hard-to-treat blood pressure.

Another exciting development is a medicine called zilebesiran, which works on the liver to stop the production of a hormone that raises blood pressure. This drug is given only twice a year, which can help people stick with treatment more easily.

Combining Old Medicines in Smarter Ways

Some newer strategies don’t involve brand-new drugs but rather combining older ones more effectively. For example, using single-pill combinations that mix two or three types of blood pressure medicines in one tablet has been shown to work better and improve adherence. This means fewer pills to take and better results for patients.

Making Treatment Personal

Genes may also affect how well someone responds to certain medicines. Scientists are now exploring how personalized treatment—based on your genetics—could improve success in managing hypertension. While this approach isn’t yet common in everyday clinics, it shows a lot of promise for the future.

Lifestyle Still Matters

No matter how good the medicines are, lifestyle changes remain a key part of controlling blood pressure. Reducing salt, exercising regularly, and maintaining a healthy weight can all make a big difference.

Conclusion

Hypertension continues to be a major health challenge, but new medications and smarter treatment strategies are giving hope. With better awareness, more accurate diagnosis, and innovative drugs like aprocitentan and zilebesiran, the future of blood pressure control looks brighter. The goal is not just to add years to life—but to make those years healthier and stronger.

Reference: https://www.nature.com/articles/s41569-025-01131-4

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