Blood pressure could be lowered with one injection in major breakthrough

A single injection could lower high blood pressure for six months, research suggests.

The drug, zilebesiran, works by preventing the production of a hormone that narrows blood vessels.

Experts said it could be a more convenient treatment than daily pills, which patients often forget to take leading to poor blood pressure control.

Study author Professor David Webb, Christison chair of therapeutics and clinical pharmacology at the University of Edinburgh, said: “This is a potentially major development in hypertension.

“There has not been a new class of drug licensed for the treatment of high blood pressure in the last 17 years.”

Around one in four adults have high blood pressure, although some are unaware. If left untreated, it can increase risk of heart attacks and strokes.

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Some 107 patients at four UK sites took part in an early trial of the drug.

Eighty received a single injection of zilebesiran under the skin, while 32 received a placebo containing no active ingredients.

Those who received the injection experienced a substantial reduction in systolic blood pressure – the force with which the heart pushes blood out and round the body – which lasted up to six months.

On average, systolic blood pressure lowered by over 10 mmHg at a 200mg dose or more of the drug, and more than 20 mmHg at the highest dose of 800mg.

A drop of this size can take someone with high blood pressure to within a much safer range, the researchers said.

Blood pressure naturally goes up and down throughout the course of the day, making it difficult to treat. But the drop seen in patients treated with zilebesiran was consistent over 24 hours.

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The drug, made by US company Alnylan, turns off the gene responsible for producing the hormone angiotensinogen.

The researchers stressed that this was a small phase one study and larger trials will be needed to robustly investigate the drug’s safety and effectiveness.

Dr Webb added: “This novel approach leads to a substantial reduction in blood pressure, both by day and night, that lasts for around six months after a single injection.

“This is attractive because it helps avoid the difficulty with adherence to treatment seen with current medicines.

“The next stage of clinical trials will focus on developing robust safety data, and broader evidence of efficacy, before zilebesiran can be licensed for use.”

Lead author Dr Akshay Desai, of Brigham and Women’s Hospital in Boston, US, said prevalence of high blood pressure was increasing across the globe.

He added: “Despite the availability of effective antihypertensive treatments, nearly half of patients with hypertension fail to achieve guideline-recommended blood pressure targets, leaving them at residual risk for myocardial infarction, stroke, kidney disease progression, and mortality.”

• The findings were published in the New England Journal of Medicine.

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