An update on the status of endothelin receptor antagonists for hypertension

Endothelin receptor antagonists (ETRA) are actively developed by the pharma ceutical industry for several cardiovascular indications. In the context of hypertension, preclinical studies are increasingly focused on prevention o r regression of end-organ damage and drug combination than on control of ar terial pressure in monotherapy, as most experimental models have already be en studied. In general, the antihypertensive effect of ETRA is limited but the overwhelming efficacy of this class of drugs to prevent several endorga n damages warrants judicious combination. However, the few studies looking at regression of hypertension-induced cardiovascular alterations proved les s successful, suggesting that ETRA should be used early in the treatment of hypertension to obtain full benefit. Judging from the progression of ongoi ng trials and the development of new trials patients suffering from pulmona ry hypertension and heart failure may be the first to benefit from this new class of drugs. However, it is expected that once on the market, responsiv e subsets of hypertensive patients will be identified and will benefit from end-organ protection.