Narrative approaches to treat hypertension: Emerging therapeutic perspectives

Various pathophysiologic facets contribute to the pathogenesis of hypertension and are root causes of cardiovascular diseases with end-organ damage. Seeing that, reninangiotensin pathway along with sympathetic nervous system are predominantly involved in HTN development and recently targeted with conventional antihypertensive therapies including diuretics, b-blockers, and calcium channel blockers, renin–angiotenin–aldosterone system antagonists with erratic results. Although current therapeutic modalities target these contributory factors but still not effectual in the apt management of blood pressure in many populations thus pointing towards the inevitability of newer pharmacological as well as non-pharmacological approaches to not only manage but cure this perplexing disorder. Aldosterone synthase inhibitor, selective aldosterone receptor antagonist, prorenin inhibitor and vasopeptidase inhibitor in company with other complementary alternatives consisting of vaccine based strategies, gene based therapeutics (targeting both vasodilatory genes along with vasoconstrictor genes), fine-tuning of endothelium-mediated responses and device base interventions including baroreflex sensitization and renal sympathetic denervation may lead to more effective , curative or preventive employment against CVS diseases. Hence, these narrative approaches in HTN therapeutics are although slow in progress but intriguing area which in future might be more beneficial in the treatment and management of hypertension in majority of populace with minimum risks.