Airo Michael, Frishman WIlliam H, Aronow Wilbert S
From the Medicine, New York Medical College, Valhalla, NY.
Department of Cardiology and Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY.
Cardiol Rev. 2025;33(2):114-119. doi: 10.1097/CRD.0000000000000591. Epub 2023 Aug 2.
Resistant hypertension (RH) is the state of uncontrolled blood pressure in the face of ostensibly optimal pharmacological intervention. It accounts for roughly one in six cases of hypertension, and is associated with more severe morbidity and mortality outcomes than is non-RH. The prevalence of RH implies a currently unmanaged pathology, which may involve the potent vasoconstrictor endothelin. Several endothelin receptor antagonists are currently marketed for pulmonary arterial hypertension, but none so far has been marketed for RH. Aprocitentan is currently in development, an endothelin receptor antagonist that effectively produces clinically significant and sustained decreases in systolic and diastolic blood pressure in the setting of RH.
