Endothelin antagonism and hypertension: an evolving target.

The impact of endothelin antagonism for the management of hypertension is a topic explored in multiple preclinical and clinical studies. Endothelin-receptor antagonists are an effective therapy for primary and resistant hypertension, but they are not widely used. This is owing to side effects shown in large clinical trials as well as the availability of many alternative agents to manage blood pressure effectively. However, the study of endothelin and its close ties to hypertension is evolving. Recent preclinical studies have explored new applications of more selective endothelin-receptor antagonists. The studies suggested that patients with certain subtypes of hypertension may benefit more from endothelin-receptor blockade than simply patients with primary hypertension. We review this and other data on this topic.