Researchers at Queen Mary University of London have reported that a new, long-acting injection could fundamentally change hypertension treatment. The findings, published in JAMA, detail a global trial involving 663 adults whose blood pressure remained high despite standard daily medication.
Participants who received the experimental drug zilebesiran alongside their usual therapy showed significantly greater reductions in blood pressure than those relying on standard treatment alone. The study, known as KARDIA-2, suggests that the drug offers a durable alternative to the daily pill regimen that many patients struggle to maintain.
Targeting the liver to manage hypertension
Zilebesiran utilizes RNA interference technology to address the root of blood pressure regulation. It functions by inhibiting the liver's production of angiotensinogen, a protein essential to the body's blood pressure control mechanisms. By suppressing this protein, the drug allows blood vessels to relax more effectively.
"Hypertension is a global health concern as blood pressure control rates remain poor and is a leading cause of heart attacks and strokes," said Dr. Manish Saxena, a hypertension specialist at Barts Health NHS Trust and senior author of the study. "This study demonstrates the efficacy and safety of zilebesiran, when added to commonly used first-line blood pressure lowering drugs."
Dr. Saxena highlighted the convenience of the new approach. "The novelty of this treatment is its long duration; giving just one injection every six months could help millions of patients to better manage their condition," he added.
High blood pressure is a widespread health issue, affecting approximately one in three adults in the United Kingdom. If left uncontrolled, the condition serves as a primary driver for fatal health events including strokes and heart attacks.
Development of the drug is ongoing. Researchers are currently engaged in a follow-up Phase 2 trial, KARDIA-3, to determine if the drug provides specific benefits for patients with established cardiovascular disease. A broader global outcomes study is scheduled for later this year to determine if the injection can directly reduce the incidence of major cardiovascular events and deaths.
The research was funded by Alnylam Pharmaceuticals. Barts Health NHS Trust served as a lead site for the trial, enrolling more participants than any other center in Europe.
