Document Detail

Novel therapeutic targets for hypertension.
MedLine Citation:
PMID:  20567239     Owner:  NLM     Status:  MEDLINE    
Despite the existence of established, effective therapies for hypertension, new methods of blood pressure and cardiovascular risk reduction are still needed. Novel approaches are targeted towards treating resistant hypertension, improving blood-pressure control, and achieving further risk reduction beyond blood-pressure lowering. Modulation of the renin-angiotensin-aldosterone system (RAAS) provides the rationale for current antihypertensive therapies, including the relatively new agents eplerenone and aliskiren. Novel targets for antihypertensive therapy are also likely to be RAAS-related. The stimulation of angiotensin II type 2 receptors, or supplementation with renalase, could counteract the effects of angiotensin II type 1 receptor stimulation or catecholamine release. Combined angiotensin-converting-enzyme and neutral endopeptidase blockade decreases blood pressure, but is associated with a high incidence of angioedema. Aldosterone synthase inhibitors might improve tolerability in aldosterone antagonism. A (pro)renin-receptor blocker could prevent the deleterious angiotensin-independent actions of renin that are not inhibited by aliskiren. Finally, new minimally invasive surgical procedures have revived the concept of renal denervation, and could be a therapeutic option for patients with resistant hypertension. All of these strategies are exciting prospects, but which of them will prove valuable in clinical setting remains to be discovered.
Ludovit Paulis; Thomas Unger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2010-06-22
Journal Detail:
Title:  Nature reviews. Cardiology     Volume:  7     ISSN:  1759-5010     ISO Abbreviation:  Nat Rev Cardiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-26     Completed Date:  2010-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101500075     Medline TA:  Nat Rev Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  431-41     Citation Subset:  IM    
Center for Cardiovascular Research, Charité-Universitätsmedizin, Hessische Strasse 3-4, 10115 Berlin, Germany.
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MeSH Terms
Antihypertensive Agents / adverse effects,  therapeutic use*
Blood Pressure / drug effects*
Drug Design
Hypertension / drug therapy*,  physiopathology,  surgery*
Kidney / innervation*
Renin-Angiotensin System / drug effects*
Treatment Outcome
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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