title: New drugs, procedures, and devices for hypertension.
abstract: Successful treatment of hypertension is difficult despite the availability of several classes of antihypertensive drug, and the value of strategies to combat the effect of adverse lifestyle behaviours on blood pressure. In this paper, we discuss two promising therapeutic alternatives for patients with resistant hypertension: novel drugs, including new pharmacological classes (such as vasopeptidase inhibitors and aldosterone synthase inhibitors) and new molecules from present pharmacological classes with additional properties in blood-pressure or metabolism pathways; and new procedures and devices, including stimulation of arterial baroreceptors and catheter-based renal denervation. Although several pharmacological targets have been discovered with promising preclinical results, the clinical development of novel antihypertensive drugs has been more difficult and less productive than expected. The effectiveness and safety of new devices and procedures should be carefully assessed in patients with resistant hypertension, thus leading to a new era of outcome trials and evidence-based guidelines.
authors.affiliation: Department of Pharmacology, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris, Paris, France. stephane.laurent@egp.aphp.fr
authors.forename: Stéphane
authors.initials: S
authors.lastname: Laurent
authors.forename: Markus
authors.initials: M
authors.lastname: Schlaich
authors.forename: Murray
authors.initials: M
authors.lastname: Esler
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000379:methods; D019405:Cytochrome P-450 CYP11B2 / Q000037:antagonists & inhibitors; D004357:Drug Synergism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000601:surgery; D007668:Kidney / Q000294:innervation; D015260:Neprilysin / Q000037:antagonists & inhibitors; D013562:Sympathectomy / Q000379:methods
chemical_list: D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D019405:Cytochrome P-450 CYP11B2; D015260:Neprilysin