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Resistant hypertension — blood pressure (BP) that remains above the target level, despite treatment with a diuretic and optimal doses of at least two other drugs — is associated with older age, obesity, diabetes, and chronic kidney disease; it confers excess cardiovascular risk. In part because of the complex nature of resistant hypertension, few prospective trials have been performed to compare therapeutic strategies.
Endothelin is a potent vasoconstrictor that might play a role in resistant hypertension, and darusentan is an experimental endothelin-receptor antagonist that is not yet FDA approved. With manufacturer funding, researchers at 117 international sites randomized 379 patients with resistant hypertension to receive one of three do…