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A jab every six months could lower blood pressure, trial results show

Huge breakthrough for millions with high blood pressure: New injection given once every six months could scrap need for daily tablets

  • One in three UK adults have high blood pressure – also known as hypertension
  • But a trial of a new drug, zilebesiran, could revolutionise the future of treatment

Just a single injection every six months could lower persistent high blood pressure, trial results suggest.

Around one in three adults in the UK and nearly half in the US have high blood pressure – also known as hypertension – and many treat the condition by taking daily tablets.

But a trial of a new drug, zilebesiran, could revolutionise the future of treatment.

The medication, developed by US-based company Alnylam, is given as an injection rather than in traditional pill form.

An international team ran early-stage clinical trials across four sites in the UK.

Around one in three adults in the UK have high blood pressure – also known as hypertension – and many treat the condition by taking daily tablets


High blood pressure, or hypertension, rarely has noticeable symptoms. But if untreated, it increases your risk of serious problems such as heart attacks and strokes.

More than one in four adults in the UK have high blood pressure, although many won’t realise it.

The only way to find out if your blood pressure is high is to have your blood pressure checked.

Blood pressure is recorded with two numbers. The systolic pressure (higher number) is the force at which your heart pumps blood around your body.

The diastolic pressure (lower number) is the resistance to the blood flow in the blood vessels. They’re both measured in millimetres of mercury (mmHg).

As a general guide:

  • high blood pressure is considered to be 140/90mmHg or higher
  • ideal blood pressure is considered to be between 90/60mmHg and 120/80mmHg
  • low blood pressure is considered to be 90/60mmHg or lower
  • A blood pressure reading between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you don’t take steps to keep your blood pressure under control.

If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes.

Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening conditions, such as:

  • heart disease
  • heart attacks
  • strokes
  • heart failure
  • peripheral arterial disease
  • aortic aneurysms
  • kidney disease
  • vascular dementia

Source: NHS

They recruited 107 patients with hypertension to take part – 80 received a single injection of zilebesiran under the skin, while 32 received a placebo containing no active ingredients.

Five patients who initially received the placebo were later moved to zilebesiran.

Analysis revealed patients who received zilebesiran 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.

Blood pressure naturally goes up and down throughout the course of the day, making it difficult to treat.

But the study found that the drop in blood pressure seen in patients who were treated with zilebesiran was consistent over 24 hours.

The drug works by preventing the production of angiotensin – a hormone in the body that narrows blood vessels, leading to raised blood pressure.

Reporting the results in the New England Journal of Medicine (NEJM), the researchers said: ‘Overall, these preliminary data… support the potential for further study of quarterly or twice-yearly administration of zilebesiran as a treatment for patients with hypertension.’

More than half of patients with high blood pressure do not take all of their prescribed medicine, leading to inconsistent blood pressure control.

Better management of the condition could reduce the risk of stroke, heart attack and premature death, experts say.

Professor David Webb, who led the trial at the Edinburgh site, 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.

‘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, from Brigham and Women’s Hospital, said: ‘Hypertension is the leading cause of premature death, cardiovascular disease and chronic kidney disease worldwide.

‘The data we have published in NEJM are exciting, suggesting the potential role for zilebesiran to treat hypertension in a novel way.’

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  • Posted on July 20, 2023