A new type of medication can help reduce blood pressure in people with un controlled hypertension, researchers reported on Saturday at the Annual Meeting of the American College of Cardiology in Chicago.
In a fundamental phase 2b clinical trial, patients who took the lorundrostat of experimental medicines along with two or three hypertension drugs currently available saw a decrease in systolic blood pressure (the upper number) that was 8 points greater than was observed in patients who obtained a placebo. The study will be published in the New England Journal of Medicine.
“This new potential therapy for hypertension is exciting,” said the main author of the study, Dr. Luke Laffin, co -director of the Center for Broken Pressure Disorders at the Heart, Vascular and Thoracic Institute of the Cleveland Clinic. “We do a bad job by controlling blood pressure in the United States”
According to centers for disease control and prevention, almost half of adults in the United States have hypertension; Among them, less than 1 in 4 have their blood pressure under control.
Hypertension is diagnosed when a person has an blood pressure of 130/80 mm Hg or more. It is considered a systolic measurement between 120 and 129 mm Hg. A normal measurement is 120/80 mm Hg or less.
Uncreated hypertension, which Laffin defined as a measurement of 130/80 mm Hg or even with medications, is linked to a greater risk of heart attacks, strokes, heart failure and renal insufficiency.
Among patients who take medications for hypertension, the control rate is 60% to 70%, said Dr. Ajay Kirtane, a cardiologist and medical professor at the Faculty of Physicians and Surgeons from the University of Columbia, which was not involved with the research. That leaves 30% to 40% of patients who need another option.
Lorundrostat is intended for this group of patients. The drug, part of a class called the synthase aldosterone inhibitors, works when blocking the synthesis of the adrenal glands of a hormone called aldosterone, which controls the amount of salt retained by the body. When aldosterone is reduced, so are salt levels and, therefore, blood pressure.
To prove the security and efficacy of Lorundrostat, Laffin and his colleagues recruited 285 adults with non -controlled hypertension whose average age was 60. More than half (53%) of the participants were black.
Black patients are among the most at risk, Laffin said. About 55% of black adults have high blood pressure, according to the American Heart Association.
Dr. Oscar Cingolani, director of the Johns Hopkins Medicine hypertension program, said that the inclusion of so many black patients is “a big big thing,” and points out that “African Americans … tend to be more receptive to this route.”
All patients in the trial were already taking a mixture of blood pressure medications. When the essay began, the researchers standardized these treatments by putting all patients in two or three specific medications. Three weeks later, they randomly assigned the participants to obtain a placebo or one of the two doses of Lorundrostat over the next 12 weeks.
In three points, the participants carried a blood pressure sleeve for a 24 -hour period: at the beginning, four weeks after the treatment began and then again at 12 weeks.
The participants who took the lowest dose of Lorundrostat, 50 milligrams, more standard medications saw an average decrease in systolic blood pressure of 15.4 points, while the group that received the placebo plus standard drugs saw a decrease of 7.4 points, so the decrease in blood pressure related to the drug after accounting for the placebo response was 8 points.
Increasing the dose of the medication did not improve the results.
While the placebo response may seem high, most likely people are in a study and have the attention of health professionals, making them more scrupulous about taking their medications, experts said.
With a decrease of 8 points, let’s say from 170 to 162, “that is the range in which you in a longer -term study will see reductions in heart attacks and blows,” said Dr. Deepak Bhatt, director of the Mount Sinai Fuster Heart Hospital in New York City.
Synthase aldosterone inhibitors are a new kind of drugs, some of which are closer to being considered for the approval of the food and medication administration than others, Bhatt said. Another, Baxdrostat, is currently in phase tests 3.
Lorundrostat has proven promising in the three levels of clinical trials necessary for approval. The last one, the phase 3 test, is completed, although the results have not yet been published, said Laffin. Researchers are working on trials with Mineralys Mineralys therapeutics, which financed the essays.
The drug could be available within 12 to 18, Laffin said.
Patients in the essay obtained Lorundrostat were more likely than those who obtained placebo to develop high potassium levels. That is something that patients would have to monitor, Bhatt said, because he can lead to abnormal heart rhythms.
Cingolani, by Johns Hopkins, said he would like to see long -term studies on the new medicine and also those who could compare Lorundrostat with an older medication that works when blocking the aldosterone receptor.
