Gene jab twice a year could send high blood pressure into reverse

DAILY pills taken by millions of people to reduce their risk of heart attack could soon be a thing of the past — thanks to a twice-yearly jab that ‘switches off’ high blood pressure.

A single dose of the drug, called zilebesiran, can control the condition for up to six months and causes few side effects, according to new trial results.

Most patients saw blood pressure drops after one injection, that could translate to a 20 per cent or more reduction in their chances of suffering a heart attack, stroke or other cardiac event.

Some in the trials have been able to quit all other blood pressure medication and there were few if any side-effects recorded.

Experts say the injections are so simple to give they could be selfadministered, much like commonly taken diabetes drugs.

The news, unveiled at the American Heart Association Scientific Sessions, in Philadelphia, was welcomed by cardiologists.

Although the early-stage study involved just a few hundred patients, the data was hailed as a potential paradigm shift in treatment of high blood pressure, a condition that’s responsible for half of all heart attacks and strokes.

Chicago-based heart expert Professor George Bakris, who was involved in the trials, said the idea of ditching ‘the burden’ of daily tablets for two injections a year was so popular his patients were ‘standing in line’ to get the drug.

‘If this lives up to its promise, it will represent a huge shift in treatment,’ he said, adding that larger trials were now needed.

High blood pressure, medically known as hypertension, affects 26 per cent of women and 38 per cent of men aged between 30-79 in Ireland. However the condition rarely has noticeable symptoms and it’s often undiagnosed, as people have never been tested.

While anyone can be affected, hypertension is more likely in those who are overweight, eat a diet high in salt and exercise little. Smokers, drinkers, the over-65s and those of African or Caribbean descent are also at greater risk.

In addition it is estimated that more than half of all patients on medication still have blood pressure high enough to put their health at risk. Dr Manish Saxena, a hypertension expert at Queen Mary University London who has been involved in clinical trials of zilebesiran, said: ‘High blood pressure is a leading risk factor for heart attacks and strokes, but many patients remain poorly controlled.

‘Patients forget to take their daily medication or struggle due to side effects.’

While patients with mild hypertension may be able to reverse the problem with lifestyle changes — increasing exercise and reducing their salt intake — many ultimately require life-long medication. A wide variety of blood pressure drugs are available but some patients may suffer swelling of the legs and hands, headaches, stomach issues, sexual dysfunction and even hair loss, said Dr Saxena. ‘This new injection seems not to cause any significant problems,’ he added.

Blood pressure can increase at night in patients on regular medication, however zilebesiran keeps blood pressure stable round the clock, further reducing heart risk.

Dr Saxena said: ‘An injection once every six months is easier for patients than daily tablets.

‘There is no reason this couldn’t be self-administered, much like injectable diabetes medication such as insulin. If it’s successful in bigger studies a treatment like this has the potential to become a new gold standard.’

Zilebesiran is a new type of drug known as small interfering RNA (siRNA). It works by switching off the gene responsible for producing antiotensinogen, a protein produced by the liver.

Antiotensinogen is needed to manufacture angiotensin, a hormone that narrows blood vessels leading to raised blood pressure.

It is believed that people with high blood pressure have too much angiotensin, and zilebesiran reduces the amount in circulation. Several existing drugs used to treat hypertension target angiotensin, but this is the first drug to cut off production at the source.

At present, the studies have involved patients only with mild to moderate high blood pressure.

‘We now hope to see bigger trials of patients with higher blood pressure and more difficult to treat problems,’ said Dr Saxena.