General Cardiology

Novel blood pressure lowering agent shows promise in resistant hypertension

Darusentan is a novel endothelin antagonist designed for the treatment of hypertension; raised levels of endothelin 1 have been reported both in patients with hypertension and those with diabetes.

Weber et al conducted a randomised, multicentre, double-blind study on the use of darusentan for resistant hypertension. Three hundred and seventy-nine patients with a systolic blood pressure of 140 mm Hg or more who were receiving at least three blood-pressure-lowering drugs were randomly assigned to 14 weeks' treatment with placebo (n=132) or darusentan 50 mg (n=81), 100 mg (n=81), or 300 mg (n=85) once a day. The primary end points were changes in sitting systolic and diastolic blood pressures.

The mean reductions in clinic systolic and diastolic blood pressures were 9/5 mm Hg with placebo, 17/10 mm Hg with darusentan 50 mg, 18/10 mm Hg with darusentan 100 mg and 18/11 mm Hg with darusentan 300 mg (p<0.0001 for all effects, see figure 1). However, oedema or fluid retention occurred in 67 (27%) patients treated with darusentan, compared with only 19 (14%) of those given placebo.

Conclusions

Darusentan is a promising new anti-hypertensive agent; however, diuretic therapy may be needed to treat any associated fluid retention. A further phase III …