Aprocitentan, a dual endothelin receptor antagonist (ERA), has shown promise in reducing systolic blood pressure in patients with treatment-resistant hypertension. The findings come from the phase 3 PRECISION trial, a multicenter, randomized study that evaluated the efficacy and safety of aprocitentan in individuals whose blood pressure remained elevated despite being on three antihypertensive drugs, including a diuretic.
The PRECISION trial enrolled patients with a systolic blood pressure of 140 mm Hg or higher, despite receiving treatment with three antihypertensive medications, one of which had to be a diuretic. The study aimed to determine if aprocitentan could provide additional blood pressure control in this difficult-to-treat population.
Endothelin is a potent vasoconstrictor, and blocking its receptors has been shown to lower blood pressure. Aprocitentan's mechanism of action, targeting both ETA and ETB receptors, may offer a more comprehensive approach to managing hypertension compared to agents that only block one receptor subtype. The results of the PRECISION trial suggest that aprocitentan could be a valuable addition to the treatment armamentarium for patients with resistant hypertension, offering a new option for achieving blood pressure control and reducing cardiovascular risk.
