Authors :
Gayathri.Vana; Dr. Nimmala Phani Satyavathi; Vaddadi.Poojitha; Imaraka.Charishma
Volume/Issue :
Volume 10 - 2025, Issue 3 - March
Google Scholar :
https://tinyurl.com/vp2k66k4
Scribd :
https://tinyurl.com/3c7yx8fk
DOI :
https://doi.org/10.38124/ijisrt/25mar486
Google Scholar
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Note : Google Scholar may take 15 to 20 days to display the article.
Abstract :
Hypertension remains a global health challenge, contributing significantly to cardiovascular morbidity and
mortality. Despite the availability of various antihypertensive drugs, many patients fail to achieve optimal blood pressure
control due to factors such as medication resistance, side effects, and patient non-adherence [1]. Recent research has led to
groundbreaking advancements in hypertension treatment, including novel pharmacological therapies, gene-targeted
interventions, and innovative non-pharmacological approaches. New classes of drugs, such as angiotensin receptor
neprilysin inhibitors (ARNIs) and endothelin receptor antagonists, have demonstrated superior efficacy in blood pressure
reduction compared to traditional therapies [2]. Additionally, gene-editing technologies like CRISPR-Cas9 are being
explored for their potential to modulate genes associated with hypertension [3]. Non-pharmacological innovations, such as
renal denervation therapy and bioelectronic medicine, offer alternative strategies for treatment-resistant hypertension [4].
Moreover, artificial intelligence (AI) and machine learning are transforming hypertension management by enabling
personalized treatment plans based on predictive analytics [5]. This article reviews these emerging therapies, their clinical
implications, and the barriers that need to be overcome for widespread adoption. The integration of these new treatment
modalities has the potential to revolutionize hypertension management and improve patient outcomes worldwide.
Keywords :
Hypertension, Antihypertensive Therapy, Renal Denervation, Gene Therapy, Artificial Intelligence, CRISPR-Cas9, Personalized Medicine, Cardiovascular Disease, Pharmacogenomics, Endothelin Receptor Antagonists
References :
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA guideline for hypertension management. J Am Coll Cardiol. 2018;71(19):e127-e248. doi:10.1016/j.jacc.2017.11.006
- Mills KT, Bundy JD, Kelly TN, et al. Global epidemiology of hypertension. J Am Coll Cardiol. 2016;67(11):1231-1241. doi:10.1016/j.jacc.2015.12.006
- Burnier M, Egan BM. Adherence in hypertension. Circ Res. 2019;124(7):1124-1140. doi:10.1161/CIRCRESAHA.118.313220
- Oparil S, Acelajado MC, Bakris GL, et al. Hypertension. Nat Rev Dis Primers. 2018;4(1):18014. doi:10.1038/nrdp.2018.14
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH guidelines on hypertension. Eur Heart J. 2018;39(33):3021-3104. doi:10.1093/eurheartj/ehy339
- NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in hypertension prevalence and progress in treatment and control. Lancet. 2021;398(10304):957-980. doi:10.1016/S0140-6736(21)01330-1
- Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990–2019. J Am Coll Cardiol. 2020;76(25):2982-3021. doi:10.1016/j.jacc.2020.11.010
- Zhou B, Perel P, Mensah GA, Ezzati M. Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension. Nat Rev Cardiol. 2021;18(11):785-802. doi:10.1038/s41569-021-00559-8
- Grassi G, Mark A, Esler M. The sympathetic nervous system alterations in human hypertension. Circ Res. 2015;116(6):976-990. doi:10.1161/CIRCRESAHA.116.303604
- Schmieder RE, Hilgers KF, Schlaich MP, Schmidt BM. Renin-angiotensin system and cardiovascular risk. Lancet. 2007;369(9568):1208-1219. doi:10.1016/S0140-6736(07)60242-6
- Virdis A, Ghiadoni L, Taddei S. Endothelial dysfunction and vascular disease in later life. Maturitas. 2010;67(1):20-24. doi:10.1016/j.maturitas.2010.04.011
- Harrison DG, Coffman TM, Wilcox CS. Pathophysiology of hypertension: The mosaic theory and beyond. Circ Res. 2021;128(7):847-863. doi:10.1161/CIRCRESAHA.121.318082
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-3104. doi:10.1093/eurheartj/ehy339
- Vrijens B, Antoniou S, Burnier M, et al. Current situation of medication adherence and persistence in hypertension. J Hypertens. 2017;35(7):1481-1491. doi:10.1097/HJH.0000000000001284
- Carey RM, Calhoun DA, Bakris GL, et al. Resistant hypertension: Detection, evaluation, and management. Hypertension. 2018;72(5):e53-e90. doi:10.1161/HYP.0000000000000084
- Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223-237. doi:10.1038/s41581-019-0244-2
- Kario K. Emerging hypertension complexity and the new strategy for risk cardiovascular management. Circ J. 2021;85(9):1612-1621. doi:10.1253/circj.CJ-21-0388
- Verdecchia P, Angeli F, Reboldi G. Beyond RAAS inhibition: An update on novel antihypertensive agents. Hypertension. 2020;76(3):884-893. doi:10.1161/HYPERTENSIONAHA.120.14735
- Padmanabhan S, Caulfield M, Dominiczak AF. Genetic and molecular aspects of hypertension. Circ Res. 2015;116(6):937-959. doi:10.1161/CIRCRESAHA.116.303647
- Omboni S, McManus RJ, Bosworth HB, et al. Evidence and recommendations on the use of telemedicine for the management of arterial hypertension. Hypertension. 2020;76(5):1368-1383. doi:10.1161/HYPERTENSIONAHA.120.15873
- Appel LJ, Brands MW, Daniels SR, et al. Dietary approaches to prevent and treat hypertension. Hypertension. 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6
- Oparil S, Schmieder RE. New approaches in the treatment of hypertension. Circ Res. 2015;116(6):1074-1095. doi:10.1161/CIRCRESAHA.116.303603
- Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-3104. doi:10.1093/eurheartj/ehy339
- McMurray JJ, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993-1004. doi:10.1056/NEJMoa1409077
- Agarwal R, Rossignol P, Romero A, et al. Effect of baxdrostat on blood pressure in treatment-resistant hypertension. Lancet. 2023;401(10382):419-431. doi:10.1016/S0140-6736(22)02119-6
- Dhaun N, Goddard J, Kohan DE, et al. Role of endothelin-1 in hypertension. Hypertension. 2008;52(4):452-459. doi:10.1161/HYPERTENSIONAHA.108.117366
- Burnier M, Polychronopoulou E, Wuerzner G. Clinical benefits of fixed-dose combination therapies in hypertension management: An update. Eur Heart J. 2020;41(27):3000-3013. doi:10.1093/eurheartj/ehz861
- Chow CK, Teo KK, Rangarajan S, et al. Prevalence, awareness, treatment, and control of hypertension in rural and urban communities in high-, middle-, and low-income countries. JAMA. 2013;310(9):959-968. doi:10.1001/jama.2013.184182
- Gradman AH, Basile JN, Carter BL, et al. Combination therapy in hypertension. J Clin Hypertens (Greenwich). 2011;13(3):146-154. doi:10.1111/j.1751-7176.2010.00410.x
- Turner ST, Schwartz GL, Chapman AB, et al. Pharmacogenomics of essential hypertension. Clin Pharmacol Ther. 2006;79(1):197-210. doi:10.1016/j.clpt.2005.11.006
- Ji W, Foo JN, O’Roak BJ, et al. Genetic analysis of blood pressure reveals novel associated loci. Hum Mol Genet. 2013;22(5):1096-1103. doi:10.1093/hmg/dds548
- Fuster V, Narula J. Emerging peptide therapies for hypertension. J Am Coll Cardiol. 2015;66(15):1692-1695. doi:10.1016/j.jacc.2015.08.020
- Hopkins CR, Groom CR. RNA-based therapeutics for hypertension. Nat Rev Drug Discov. 2022;21(6):413-431. doi:10.1038/s41573-021-00284-6
- Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for hypertension. J Am Coll Cardiol. 2014;63(12):1235-1238. doi:10.1016/j.jacc.2013.11.005
- Joseph JJ, Echouffo-Tcheugui JB, Golden SH. New insights into the epidemiology of hypertension-mediated end-organ damage. Curr Hypertens Rep. 2017;19(8):76. doi:10.1007/s11906-017-0760-3
- Messerli FH, Bangalore S, Bavishi C, Rimoldi SF. Angiotensin receptor blockers and risk of cancer. Lancet Oncol. 2018;19(3):e127-e136. doi:10.1016/S1470-2045(18)30098-7
- Carretero OA, Oparil S. Essential hypertension: part I: definition and etiology. Circulation. 2000;101(3):329-335. doi:10.1161/01.CIR.101.3.329
- Rimoldi SF, Scherrer U, Messerli FH. Secondary arterial hypertension: when, who, and how to screen? Eur Heart J. 2014;35(19):1245-1254. doi:10.1093/eurheartj/eht534
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA guideline for hypertension management. J Am Coll Cardiol. 2018;71(19):e127-e248. doi:10.1016/j.jacc.2017.11.006
- McMurray JJ, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993-1004. doi:10.1056/NEJMoa1409077
- Williams B, Cockcroft JR, Kario K, et al. Effects of sacubitril/valsartan versus olmesartan on central hemodynamics in the elderly. Hypertension. 2017;69(3):411-420. doi:10.1161/HYPERTENSIONAHA.116.08424
- Patel P, Cattran D. The role of aldosterone synthase inhibitors in managing hypertension. J Clin Hypertens. 2020;22(1):10-15. doi:10.1111/jch.13811
- Rocha R, Funder JW. The role of aldosterone in cardiovascular disease. J Clin Endocrinol Metab. 2002;87(11):4754-4756. doi:10.1210/jc.2002-021078
- Davenport AP, Hyndman KA, Dhaun N, et al. Endothelin. Pharmacol Rev. 2016;68(2):357-418. doi:10.1124/pr.115.011833
- Galiè N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2016;37(1):67-119. doi:10.1093/eurheartj/ehv317
- Azizi M, Amar L, Gosse P, et al. Endothelin receptor antagonists for hypertension treatment: Current status and future perspectives. Curr Hypertens Rep. 2021;23(7):24. doi:10.1007/s11906-021-01133-2
- Oparil S, Schmieder RE. New approaches in the treatment of hypertension. Circ Res. 2015;116(6):1074-1095. doi:10.1161/CIRCRESAHA.116.303603
- Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the DASH diet. N Engl J Med. 2001;344(1):3-10. doi:10.1056/NEJM200101043440101
- Appel LJ, Brands MW, Daniels SR, et al. Dietary approaches to prevent and treat hypertension. Hypertension. 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA guideline for hypertension management. J Am Coll Cardiol. 2018;71(19):e127-e248. doi:10.1016/j.jacc.2017.11.006
- He FJ, MacGregor GA. A comprehensive review on salt and health. J Hum Hypertens. 2009;23(7):363-384. doi:10.1038/jhh.2008.144
- Piercy KL, Troiano RP, Ballard RM, et al. The physical activity guidelines for Americans. JAMA. 2018;320(19):2020-2028. doi:10.1001/jama.2018.14854
- Cornelissen VA, Smart NA. Exercise training for blood pressure: A systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):e004473. doi:10.1161/JAHA.112.004473
- Neter JE, Stam BE, Kok FJ, et al. Influence of weight reduction on blood pressure: A meta-analysis of randomized controlled trials. Hypertension. 2003;42(5):878-884. doi:10.1161/01.HYP.0000094221.86888.AE
- Beilin LJ, Puddey IB. Alcohol and hypertension: An update. Hypertension. 2006;47(6):1035-1038. doi:10.1161/01.HYP.0000226111.17020.7a
- Virdis A, Giannarelli C, Neves MF, et al. Cigarette smoking and hypertension. Curr Pharm Des. 2010;16(23):2518-2525. doi:10.2174/138161210792062920
- Eisenberg MJ, Filion KB, Yavin D, et al. Pharmacotherapies for smoking cessation: A meta-analysis of randomized controlled trials. CMAJ. 2008;179(2):135-144. doi:10.1503/cmaj.070256
- Palta P, Page G, Piferi RL, et al. Evaluation of a mindfulness-based intervention program to decrease blood pressure in low-income African-American older adults. J Urban Health. 2012;89(2):308-316. doi:10.1007/s11524-011-9644-z
- Elmer PJ, Obarzanek E, Vollmer WM, et al. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: The PREMIER clinical trial. JAMA. 2006;298(19):2083-2093. doi:10.1001/jama.298.19.2083
- Sacks FM, Svetkey LP, Vollmer WM, et al. Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med. 2001;344(1):3-10. doi:10.1056/NEJM200101043440101
- Appel LJ, Brands MW, Daniels SR, et al. Dietary approaches to prevent and treat hypertension. Hypertension. 2006;47(2):296-308. doi:10.1161/01.HYP.0000202568.01167.B6
- Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):e004473. doi:10.1161/JAHA.112.004473
- Pescatello LS, MacDonald HV, Lamberti L, et al. Exercise for hypertension: A prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep. 2015;17(11):87. doi:10.1007/s11906-015-0600-y
- Blumenthal JA, Sherwood A, Smith PJ, et al. Enhancing cardiac rehabilitation with stress management training. Circ. 2016;133(14):1341-1350. doi:10.1161/CIRCULATIONAHA.115.018926
- Park SH, Han KS. Blood pressure response to meditation and yoga: A systematic review and meta-analysis. J Altern Complement Med. 2017;23(9):685-695. doi:10.1089/acm.2017.0087
- Flachskampf FA, Gallasch J, Gefeller O, et al. Randomized trial of acupuncture to lower blood pressure. Circulation. 2007;115(24):3121-3129. doi:10.1161/CIRCULATIONAHA.106.683201
- Faulkner MS. Cardiovascular fitness and quality of life in adolescents with type 1 or type 2 diabetes. J Spec Pediatr Nurs. 2010;15(4):307-316. doi:10.1111/j.1744-6155.2010.00251.x
- Dickinson HO, Mason JM, Nicolson DJ, et al. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens. 2006;24(2):215-233. doi:10.1097/01.hjh.0000199800.72563.26
- Yusuf S, Sleight P, Pogue J, et al. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med. 2000;342(3):145-153. doi:10.1056/NEJM200001203420301
- Dahlöf B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomized trial against atenolol. Lancet. 2002;359(9311):995-1003. doi:10.1016/S0140-6736(02)08089-3
- Staessen JA, Li Y, Richart T. Oral antihypertensive treatment and blood pressure reduction: clinical implications. J Hypertens. 2006;24(2):235-242. doi:10.1097/01.hjh.0000199802.11176.7f
- Brown MJ, Cruickshank JK, Dominiczak AF, et al. Better blood pressure control: combining calcium channel blockers with other agents. J Hum Hypertens. 2003;17(1):81-85. doi:10.1038/sj.jhh.1001507
- Wright JM, Musini VM. First-line drugs for hypertension. Cochrane Database Syst Rev. 2009;(3):CD001841. doi:10.1002/14651858.CD001841.pub2
- Williams B, MacDonald TM, Morant S, et al. Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): a randomized, double-blind, crossover trial. Lancet. 2015;386(10008):2059-2068. doi:10.1016/S0140-6736(15)00257-3
- Bangalore S, Messerli FH, Wun CC, et al. Cardiovascular protection using beta-blockers: A critical review of the evidence. J Am Coll Cardiol. 2007;50(7):563-572. doi:10.1016/j.jacc.2007.04.073
- Funder JW, Carey RM, Mantero F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016;101(5):1889-1916. doi:10.1210/jc.2015-4061
- Calhoun DA, White WB. Effectiveness of aldosterone antagonists in resistant hypertension. Hypertension. 2008;51(3):747-752. doi:10.1161/HYPERTENSIONAHA.107.105122
- Iglarz M, Clozel M. Endothelin receptor antagonists: past, present, and future. Curr Opin Pharmacol. 2010;10(2):176-181. doi:10.1016/j.coph.2009.12.003
- Ruilope LM, Agarwal R. Neprilysin inhibition and angiotensin receptor blockade in heart failure and hypertension. J Hypertens. 2018;36(7):1513-1523. doi:10.1097/HJH.0000000000001761
- Turner ST, Bailey KR, Schwartz GL, et al. Genomic predictors of antihypertensive response to metoprolol and hydrochlorothiazide. Hypertension. 2012;59(5):1133-1140. doi:10.1161/HYPERTENSIONAHA.111.190850
- Johnson JA, Cavallari LH. Pharmacogenetics and cardiovascular disease—implications for personalized medicine. Pharmacol Rev. 2013;65(3):987-1009. doi:10.1124/pr.112.007252
- Pereira TV, Polonia J, Monteiro EC. Pharmacogenetics of antihypertensive therapy. Pharmacogenomics J. 2011;11(1):1-11. doi:10.1038/tpj.2010.15
- Dhaun N, Webb DJ. Endothelins in cardiovascular biology and therapeutics. Nat Rev Cardiol. 2019;16(8):491-502. doi:10.1038/s41569-019-0187-7
- Ruilope LM, Tamargo J. Aldosterone synthase inhibitors in hypertension. J Clin Hypertens. 2018;20(1):4-10. doi:10.1111/jch.13161
- Tucker KL, Sheppard JP, Stevens R, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389. doi:10.1371/journal.pmed.1002389
- Green BB, Anderson ML, Ralston JD, et al. Patient-centered web services for hypertension management: a randomized controlled trial. JAMA Intern Med. 2013;173(10):957-965. doi:10.1001/jamainternmed.2013.2751
- Marques FZ, Mackay CR, Kaye DM. Beyond gut feelings: how the gut microbiota regulates blood pressure. Nat Rev Cardiol. 2018;15(1):20-32. doi:10.1038/nrcardio.2017.120
- Khalesi S, Sun J, Buys N, et al. Effect of probiotics on blood pressure: a systematic review and meta-analysis of randomized, controlled trials. Hypertension. 2014;64(4):897-903. doi:10.1161/HYPERTENSIONAHA.114.03469
- Omboni S. Telemedicine during the COVID-19 in Italy: a missed opportunity? Telemed J E Health. 2020;26(9):973-975. doi:10.1089/tmj.2020.0106
- Bove AA. Telemedicine and hypertension management. J Clin Hypertens. 2020;22(9):1470-1474. doi:10.1111/jch.13988
- Oparil S, Schmieder RE. New approaches in the treatment of hypertension. Circ Res. 2015;116(6):1074-1095. doi:10.1161/CIRCRESAHA.116.303603
- Johnson JA, Cavallari LH. Pharmacogenetics and cardiovascular disease—implications for personalized medicine. Pharmacol Rev. 2013;65(3):987-1009. doi:10.1124/pr.112.007252
- Ruilope LM, Tamargo J. Aldosterone synthase inhibitors in hypertension. J Clin Hypertens. 2018;20(1):4-10. doi:10.1111/jch.13161
- Tucker KL, Sheppard JP, Stevens R, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389. doi:10.1371/journal.pmed.1002389
- Marques FZ, Mackay CR, Kaye DM. Beyond gut feelings: how the gut microbiota regulates blood pressure. Nat Rev Cardiol. 2018;15(1):20-32. doi:10.1038/nrcardio.2017.120
- Omboni S. Telemedicine during the COVID-19 in Italy: a missed opportunity? Telemed J E Health. 2020;26(9):973-975. doi:10.1089/tmj.2020.0106
- Oparil S, Schmieder RE. New approaches in the treatment of hypertension. Circ Res. 2015;116(6):1074-1095. doi:10.1161/CIRCRESAHA.116.303603
Hypertension remains a global health challenge, contributing significantly to cardiovascular morbidity and
mortality. Despite the availability of various antihypertensive drugs, many patients fail to achieve optimal blood pressure
control due to factors such as medication resistance, side effects, and patient non-adherence [1]. Recent research has led to
groundbreaking advancements in hypertension treatment, including novel pharmacological therapies, gene-targeted
interventions, and innovative non-pharmacological approaches. New classes of drugs, such as angiotensin receptor
neprilysin inhibitors (ARNIs) and endothelin receptor antagonists, have demonstrated superior efficacy in blood pressure
reduction compared to traditional therapies [2]. Additionally, gene-editing technologies like CRISPR-Cas9 are being
explored for their potential to modulate genes associated with hypertension [3]. Non-pharmacological innovations, such as
renal denervation therapy and bioelectronic medicine, offer alternative strategies for treatment-resistant hypertension [4].
Moreover, artificial intelligence (AI) and machine learning are transforming hypertension management by enabling
personalized treatment plans based on predictive analytics [5]. This article reviews these emerging therapies, their clinical
implications, and the barriers that need to be overcome for widespread adoption. The integration of these new treatment
modalities has the potential to revolutionize hypertension management and improve patient outcomes worldwide.
Keywords :
Hypertension, Antihypertensive Therapy, Renal Denervation, Gene Therapy, Artificial Intelligence, CRISPR-Cas9, Personalized Medicine, Cardiovascular Disease, Pharmacogenomics, Endothelin Receptor Antagonists