High blood pressure cure may have found its Eureka moment. Just two injections a year could replace daily tables.
What once seemed a miracle could be a reality, although trials on this breakthrough are in the nascent stage. An announcement is expected soon.
A new review highlights the scale of this shift. Effective antihypertensive drugs have existed for years. Yet global blood pressure control remains poor. The problem is not a lack of medicines. Experts told media outlets that it’s a failure of systems, adherence and long-term engagement.
Hypertension remains the leading cause of heart attacks, strokes and premature death worldwide. The World Health Organisation defines it as systolic blood pressure at or above 140 mm Hg and/or diastolic pressure at or above 90 mm Hg.
Systolic pressure is the force when the heart pumps blood into arteries. Diastolic pressure is the force when the heart rests between beats. Normal blood pressure is below 120/80 mm Hg.
The global burden is severe. As a report highlights, in 2024–2025, about 1.4 billion adults aged 30 to 79 live with hypertension. That is roughly one in three people in this age group. Nearly 44 percent do not know they have the condition, it adds. Among those diagnosed, fewer than one in four have adequate control.
India reflects the same crisis.
The Indian Council of Medical Research–INDIAB study, published in 2023, estimated that 315 million Indians have hypertension, the report mentions.
That equals 35.5 percent of the population. Control rates are worrying. A secondary analysis of National Family Health Survey-5 data showed that nearly half of hypertensive men and more than one-third of hypertensive women in India do not have controlled blood pressure.
For decades, treatment has relied on daily oral medicines. Guidelines usually recommend two or more drugs in combination. These include ACE inhibitors that relax blood vessels. They include angiotensin receptor blockers paired with calcium channel blockers. They also include thiazide or thiazide-like diuretics that remove excess salt and water.
In theory, these regimens work well. In practice, adherence is weak. Many patients also have diabetes, obesity or abnormal cholesterol. This leads to polypharmacy. Patients take multiple pills several times a day.
Over time, missed doses occur. Side effects appear. Treatment fatigue sets in. Effectiveness declines. Therapeutic inertia adds to the problem. Medicines are not intensified even when blood pressure remains uncontrolled.
This is where long-acting injectables enter the picture.
Experts believe the field is moving decisively toward injectables given twice a year.
These new agents differ from conventional medicines. Traditional drugs work downstream to lower blood pressure numbers. The new therapies act upstream. They target molecular pathways that drive hypertension.
The review describes therapies beyond traditional drug classes. One approach uses small interfering RNA agents. These inhibit angiotensinogen synthesis. They silence angiotensinogen production in the liver. This dampens the renin–angiotensin system. That system is central to blood pressure regulation.
Zilebesiran, developed by Roche Pharma and Alnylam, is reportedly among the most advanced candidates. It is in global phase 3 trials. Phase 2 results were promising.
Another candidate is ziltivekimab from Novo Nordisk. It is a monoclonal antibody. It reportedly targets inflammatory pathways linked to cardiovascular risk. Chronic inflammation is increasingly recognised as a contributor to vascular dysfunction and hypertension. By modulating inflammatory signalling, these therapies aim to reduce blood pressure. They also aim to lower broader cardiovascular risk.
Other strategies focus on aldosterone. This hormone is produced by the adrenal glands. It causes the kidneys to retain sodium and water. It makes them excrete potassium. Excess aldosterone increases blood volume. This raises blood pressure. More precise control of this pathway may offer sustained benefits with fewer side effects.
The appeal of these therapies is durability. A twice-yearly injection ensures steady drug exposure. It removes the daily pill burden. It may greatly improve adherence. In theory, this could mean more stable blood pressure control. It could mean fewer heart attacks and strokes over time.
If successful, these treatments could redefine hypertension care. Management could shift from daily compliance to long-acting precision therapy.
Cost is a major concern. The case of inclisiran offers a warning. This injectable therapy lowers LDL cholesterol. It was introduced in India in 2024. It costs between Rs 1.8 lakh and Rs 2.4 lakh per year. Many patients cannot afford it.
If hypertension injectables are priced similarly, access may suffer. This would be especially serious in low- and middle-income countries. These countries carry the highest burden of hypertension.
Long-term safety is another open question. Early and mid-stage trials show encouraging results. But hypertension is lifelong. Patients may need treatment for decades. Strong evidence on long-term effects is essential. Data on rare adverse events is needed. Safety in diverse populations must be confirmed before wide adoption.
However, a twice-yearly injection that reliably controls blood pressure could reduce treatment burden for millions. The real test will go beyond clinical efficacy. Affordability will matter, so will accessibility.
Also Read: Fit, Clean ECG, Yet Fatal: Hidden Heart Risks Behind Sudden Cardiac Death https://www.vibesofindia.com/fit-clean-ecg-yet-fatal-hidden-heart-risks-behind-sudden-cardiac-death/
