Treatment of Resistant Hypertension With Endovascular Baroreflex Amplification: 3-Year Results From the CALM-FIM Study. (2025)

FAQs

What is the new treatment for resistant hypertension? ›

The US Food and Drug Administration (FDA) has approved aprocitentan (Tryvio) to lower blood pressure, in combination with other antihypertensive agents, in adults with treatment-resistant hypertension. Aprocitentan is the first endothelin receptor antagonist approved for patients with hypertension.

Most people with resistant hypertension can manage their blood pressure with medication. In addition to prescribing medication, your provider might need to try some different approaches, like replacing one diuretic with a stronger one or having you take one of your non-diuretic medicines at night.

Aldosterone excess is common in patients with resistant hypertension, and addition of spironolactone or amiloride to the standard 3-drug antihypertensive regimen is effective at getting the blood pressure to goal in most of these patients.

Baroreflex activation therapy is a novel technique for treating patients with resistant hypertension. Although short-term studies have demonstrated that it lowers blood pressure, long-term results have not yet been reported.

If you have resistant hypertension – high blood pressure that does not respond to 3 or more drugs – you may be entitled to Social Security Disability benefits. It is important that you have an ambulatory blood pressure readings if you have resistant hypertension.

As the arteries become narrower and less flexible, the heart has to work harder to move blood through the body. Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure and other heart conditions; cause damage to your kidneys, memory and vision; and contribute to erectile dysfunction.

Patients with resistant hypertension are at higher risk of complications including cardiovascular disease, stroke, kidney failure, and death. It is important to identify common factors that contribute to resistant hypertension to mitigate their effects.

Your Resistant Hypertension Care Team

There are many healthcare providers you might meet throughout your journey, including: Cardiologists (heart specialists). Nephrologists (kidney specialists). Endocrinologists (hormone specialists).

Spironolactone is the most effective fourth medication for treating RHTN in patients already on treatment with triple regimens that include an ACE inhibitor or ARB, amlodipine, and a thiazide-like diuretic.

What is the surgery for resistant hypertension? ›

Renal denervation (also called renal ablation) is a minimally invasive, investigational procedure to treat hypertension (high blood pressure) that hasn't improved with other treatments. This type of hypertension is called resistant hypertension.

Patients were randomly assigned to receive either the combination pill or usual care – their doctor's choice of blood pressure lowering medication. The Triple Pill, consisted of the commonly used blood pressure medications telmisartan (20 mg), amlodipine (2.5 mg), and chlorthalidone (12.5 mg).

The outcome for baroreflex failure can vary depending on factors such as the underlying cause of the condition, the severity of symptoms, response to treatment, and a person's overall health. Often, the condition responds to treatment.

Clonidine attenuates the pressor and tachycardic surges in baroreflex failure.

Any change in your body's demand for blood can trigger your baroreceptor reflex. For example, your body may need to adjust your blood pressure when you: Change your body position, such as when you stand. See or experience something that frightens you.

Spironolactone is the most effective fourth medication for treating RHTN in patients already on treatment with triple regimens that include an ACE inhibitor or ARB, amlodipine, and a thiazide-like diuretic.

It was therefore with cautious optimism that on March 19, 2024, the US Federal Drug Administration (FDA) approved aprocitentan (TRYVIO™) an endothelin (ET) receptor antagonist (ETRA) for resistant hypertension. This is the first new class of oral antihypertensive medicines to be approved by the FDA in almost 40 years.