A novel approach for the treatment of hypertension with the soluble guanylate cyclase stimulating drug

ABSTRACT

Introduction

Despite the significant progress in the development of safe and effective antihypertensive drugs, the control of blood pressure (BP) is still not satisfactory. The current antihypertensive drugs reduce the BP by increasing sodium and water excretion (diuretics), by blocking the action of the sympathetic system, by blocking the calcium entry into vascular smooth muscle cells, or by blocking the action of the renin-angiotensin-aldosterone system.

Areas Covered

There is a need for the development of new antihypertensive drugs with a different mechanism of action. This new class of drugs are the soluble guanylate cyclase (sGC) stimulators and decrease the BP through arterial vasodilation by stimulating the sGC and increasing the production of cyclic-guanosine-monophosphate (cGMP), a potent vasodilator, independently of the endogenous nitric oxide. However, there is limited research on their antihypertensive action. For further knowledge of the antihypertensive effects and safety of these drugs, a focused Medline search of the English language literature was conducted between 2010 and 2020 and 27 studies with pertinent information were selected.

Expert Opinion

The analysis of data from these demonstrated that these drugs are safe and have beneficial antihypertensive and metabolic effects and they will be useful for hypertensive patients with diabetes and dyslipidemia.

KEYWORDS:

• Nitric oxide
• soluble guanylate cyclase stimulators
• mechanism of action
• hypertension
• safety

Article highlights

• The sGC stimulators increase the production of cGMP, a potent vasodilator

• They decrease BP through active vasodilation in combination with native NO

• They possess pluripotential cardiovascular antiremodeling and metabolic beneficial effects and have long duration of action, which makes them suitable for once/day administration

• They are quite safe drugs with small incidence of bleeding from antiplatelet action

• Their further development and approval will be a significant addition to our antihypertensive armamentarium

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

Peer reviewers in this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.