New and emerging cardiovascular and antihypertensive drugs

ABSTRACT

Introduction

Hypertension and cardiovascular diseases (CVD) are very common conditions and account for significant medical disability and death worldwide. Therefore, their successful management is very critical for the prevention of the significant cardiovascular and socioeconomic consequences arising from their poor management.

Areas Covered: Although we have several effective cardiovascular (CV) drugs for their treatment, they are not all completely successful for the effective management of CVD and hypertension. Thus, the need for the discovery and development of new drugs is necessary. For this review, a Medline search of the English language was conducted between 2010 and June 2020 and 62 pertinent papers were retrieved. These papers contain information on newly released and emerging new cardiovascular drugs.

Expert opinion

These new chemical entities have different mechanisms of action and in preliminary studies have been successful in the treatment of hypertension, CVD, heart failure, stroke, and type 2 diabetes mellitus. These drugs can be used either alone or in combination with other antihypertensive and cardiovascular drugs. Hopefully, these new classes of cardiovascular drugs would be effective for the treatment of hypertension and CVD and decrease their socioeconomic consequences.

KEYWORDS:

• Hypertension
• cardiovascular disease
• heart failure
• diabetes mellitus
• new drug

Article highlights

• The sacubitril/valsartan exerts its beneficial effects on HFrEF and hypertension through volume contraction with neprilysin and vasodilation through blockade of Ang II receptor with valsartan.

• The SGLT2 inhibitors exert their beneficial effects on T2DM and CVD through improvement of T2DM, weight loss, vasodilation, and reduction of BP.

• Finerenone exerts beneficial effects on HF and hypertension through a more selective blockade of aldosterone and increase in diuresis and natriuresis.

• Firabastat exerts its antihypertensive effects through central blockade of RAS and vasopressin release causing vasodilation and plasma volume contraction.

• The endothelin inhibitors bosentan, darusentan, and others exert their antihypertensive effects through peripheral vasodilation.

• Vericinguat promises beneficial effects on HF and hypertension through peripheral vasodilation by stimulating the release of nitric oxide.

This box summarizes key points contained in the article.

Acknowledgments

The authors wish to express their appreciation to Lisa Marie Zarrella, chief librarian of INTEGRIS Baptist Medical Center for her help in retrieving several papers for the preparation of this manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they have served as a consultant for Bayer (finerenone); Sanofi/Lexicon (sotagliflozin); KBP pharmaceuticals *(KBP 5074), Relypsa/Vifor * (patiromer); Sarfez* (extended release torsemide); AstraZeneca, SC Pharmaceuticals*; SQinnovations*, G3ppharmaceuticals*; and Cereno Scientific* (*=stock options). They also hold US patent 9931412-site specific delivery of eplerenone to the myocardium. All other peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.