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Cleveland Clinic-led Trial Shows Promising Initial Results for New Class Of Medication to Treat Resistant Hypertension

CLEVELAND: In an area that has not seen significant developments for several years, a new type of hypertension medication has shown encouraging results in a second phase of clinical trials, offering hope to individuals with high blood pressure that does not respond to conventional treatments, an expert from global health system Cleveland Clinic says ahead of World Heart Day.

According to World Health Organization estimates, 1.28 billion adults aged 30–79 years worldwide have hypertension, and only around 21% of people with high blood pressure have it under control. While some people with high blood pressure might be undiagnosed or untreated, others have blood pressure that remains high despite medication.

“Uncontrolled blood pressure, also known as resistant hypertension, is a leading risk factor for cardiovascular disease-related morbidity and deaths worldwide,” says preventive cardiologist Luke Laffin, MD, who is Co-Director of Cleveland Clinic’s Center for Blood Pressure Disorders.

According to Dr. Laffin, hypertension is defined as ‘resistant’ when blood pressure remains at unsafe levels despite optimal use of three different classes of antihypertensive medications, including a diuretic.

Dr. Laffin is the lead investigator in ongoing clinical trials investigating the safety and efficacy of lorundrostat, a potential new class of drug for treating resistant hypertension. “Lorundrostat works by reducing the body’s production of aldosterone, a hormone the adrenal glands release to help regulate blood pressure through managing the levels of sodium and potassium in the blood,” explains Dr. Laffin.

In the recent phase-two multicenter trial, lorundrostat was found to be effective in safely reducing blood pressure in patients, and indications are that it might be particularly useful for patients with obesity-related high blood pressure. The results of the study were published in the Journal of the American Medical Association this month.

“While these are early studies, the results are encouraging as the medication could offer an alternative to the current treatment for resistant hypertension, namely, mineralocorticoid receptor antagonists (MRAs). This is significant as MRAs can have side effects including hyperkalemia, or excessive amounts of potassium in the blood, and hormonal changes, which can preclude some patients from taking them.”

Dr. Laffin says Cleveland Clinic is participating in other important studies of lorundrostat, and will begin enrolling patients soon.

Tips for managing blood pressure:

“As hypertension can cause serious damage to the heart, World Heart Day is an opportunity to remind people to have their blood pressure checked,” says Dr. Laffin. “People with high blood pressure might not have any symptoms, so it’s important to have your blood pressure assessed regularly by a professional. Patients who are given medication must ensure they are taking it as prescribed, and if they find their blood pressure is still not under control, they should speak to their healthcare provider about trying different medications.”

Dr Laffin says that while the guidelines differ around the world, today many physicians advise targeting a blood pressure reading below 130/80.

In addition to medication, lifestyle changes can also help to reduce blood pressure levels, Dr Laffin adds. These changes include:

  • eating healthily by, for example, following a Mediterranean diet focusing on fruits, vegetables, whole grains, fish, lean meats and olive oil;
  • getting regular exercise;
  • not smoking; and
  • limiting intake of salt, alcohol and trans and saturated fat.

About Cleveland Clinic:

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognized in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 77,000 employees worldwide are more than 5,658 salaried physicians and researchers, and 19,000 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,699-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, more than 275 outpatient facilities, including locations in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2022, there were 12.8 million outpatient encounters, 303,000 hospital admissions and observations, and 270,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 185 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/ClevelandClinic. News and resources available at newsroom.clevelandclinic.org.

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