Irfan Hamza, Ahmed Aliza, Nawani Komal Devi
Department of Cardiology, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College Lahore, Lahore, Punjab, Pakistan.
Department of Cardiology, Jinnah Sindh Medical University, Karachi City, Sindh, Pakistan.
Curr Probl Cardiol. 2024 Jan;49(1 Pt C):102144. doi: 10.1016/j.cpcardiol.2023.102144. Epub 2023 Oct 18.
Hypertension, characterized by persistent high blood pressure levels, is a major global health concern, contributing significantly to the risk of cardiovascular diseases (CVD) and overall mortality. It is classified into primary and secondary hypertension, with its prevalence steadily increasing due to ageing populations and unhealthy lifestyle factors. The World Health Organization (WHO) reports a staggering rise in hypertension cases, affecting one in 3 adults worldwide, doubling from 1990 to 2019. A significant development in the field of hypertension treatment is the Target-HTN trial, which investigated the efficacy of lorundrostat, an aldosterone synthase inhibitor, in reducing systolic blood pressure. This trial involved 2 cohorts. Cohort 1, comprising patients with suppressed plasma renin activity and elevated serum aldosterone levels, showed promising results. Lorundrostat doses of 100 mg and 50 mg administered once daily led to substantial reductions in systolic blood pressure compared to a placebo group. Cohort 2, although considered exploratory, also exhibited a notable reduction in systolic blood pressure with a 100 mg once-daily dose of lorundrostat. In conclusion, the Target-HTN trial has demonstrated that lorundrostat, an aldosterone synthase inhibitor, holds promise as an innovative therapeutic approach for reducing systolic blood pressure, especially in hypertensive patients with suppressed plasma renin activity and elevated serum aldosterone levels. These findings advocate for the initiation of Phase 3 trials to further validate the safety and efficacy of lorundrostat in a larger and more diverse patient population.
高血压的特征是血压持续处于高水平,是一个重大的全球健康问题,对心血管疾病(CVD)风险和总体死亡率有重大影响。它分为原发性和继发性高血压,由于人口老龄化和不健康的生活方式因素,其患病率在稳步上升。世界卫生组织(WHO)报告称,高血压病例惊人地增加,全球每3名成年人中就有1人受影响,从1990年到2019年增加了一倍。高血压治疗领域的一项重大进展是Target-HTN试验,该试验研究了醛固酮合酶抑制剂洛伦德司他降低收缩压的疗效。该试验涉及2个队列。队列1由血浆肾素活性受抑制且血清醛固酮水平升高的患者组成,显示出有希望的结果。与安慰剂组相比,每天一次给予100 mg和50 mg的洛伦德司他剂量可使收缩压大幅降低。队列2虽然被视为探索性的,但每天一次给予100 mg洛伦德司他剂量时,收缩压也有显著降低。总之,Target-HTN试验表明,醛固酮合酶抑制剂洛伦德司他有望成为降低收缩压的一种创新治疗方法,特别是对于血浆肾素活性受抑制且血清醛固酮水平升高的高血压患者。这些发现主张开展3期试验,以在更大且更多样化的患者群体中进一步验证洛伦德司他的安全性和疗效。