Novel therapies on the horizon of hypertension management.

The rates of uncontrolled hypertension and downstream cardiovascular outcomes have been worsening in the United States. Despite the plethora of antihypertensive medications available, the prevalence of resistant hypertension is estimated to be 13.7%. Therefore, in addition to increased clinical education, focus on lifestyle management of hypertension, and medication adherence, new therapies are needed to address this rise in hypertension. Five relatively novel classes of promising medications and two procedural interventions are being developed to expand our treatment arsenal for patients with resistant hypertension. This article reviews some of the new pharmacologic classes of antihypertensive therapy, including non-steroidal mineralocorticoid receptor antagonists, aminopeptidase A inhibitors, dual endothelin antagonists, aldosterone synthetase inhibitors, agents affecting atrial natriuretic peptide, and attenuators of hepatic angiotensinogen. Additionally, an overview of renal denervation and carotid baroreceptor stimulation is presented. Based on the available data and no new issues with safety, there will be at least two to three novel agents as well as a new procedure to deal with resistant hypertension within the next two to three years.