Future Prospects

ARBs represent nearly optimal symptomatic therapy of hypertension. They are effective in the great majority of patients and have minimal side effects. They increase Ang II levels in blood, but, since AT receptors are blocked, accumulation of Ang II appears not to lead to any harmful effects. Aliskiren or other renin inhibitors could conceivably be as effective as ARBs without increasing blood levels of Ang II. ACEIs are widely used. Their disadvantages include bradykinin-induced cough and inability to block Ang II synthesis completely. There are currently no other competitors for ARBs. It is anticipated that drug combinations will be more extensively used. Future research efforts are likely to be directed toward prevention of cardiovascular disease by mechanisms other than lowering of arterial pressure as well as to curative rather than symptomatic treatment of hypertension. It is conceivable that vascular changes can be prevented or reduced by antagonists of various cytokines better than by ACEIs or ARBs, leading to a greater decrease in morbidity and mortality from cardiovascular diseases.

Since genetic factors play an important role in the pathogenesis of essential hypertension, gene therapy of hypertension will be attempted in humans. Experimental studies in animals indicate its feasibility.50 Genetic approaches to the treatment of hypertension do not necessarily require identification of the gene mutation responsible for hypertension in an individual or family. Sustained reduction of arterial pressure has been achieved in SHRs by retroviral delivery of ACE antisense,51 and ATi receptor antisense cDNA prevented the development of hypertension in SHRs. Antisense oligonucleotides technology is considered a highly promising strategy to inhibit specific gene expression and consequently the progress of hypertension.52 Modifications of the current gene delivery systems and use of efficacious therapeutic genes may lead to successful gene therapy of cardiovascular diseases. However, gene therapy of hypertension has many obstacles to overcome and may not become a reality in the near future.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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