portal hypertension related to cirrhosis

Hypertension remains the most common treatable cardiovascular risk factor globally, yet blood pressure control rates remain suboptimal despite multiple effective drug classes. Clinical trials now investigate novel mechanisms including aldosterone synthase inhibitors, renal denervation devices, and RNA-based therapies targeting angiotensinogen to achieve durable pressure reduction with minimal pill burden.

Active research includes zilebesiran (RNA interference targeting angiotensinogen), baxdrostat (aldosterone synthase inhibitor), ultrasound renal denervation (Symplicity HTN-4), and resistant hypertension approaches combining SGLT2 inhibitors with MRA spironolactone. Ambulatory blood pressure monitoring is increasingly used as the primary endpoint instead of clinic readings.