Final Takeaways of Dual Endothelin Receptor Antagonists: Ideal Patients and Management Pearls

Health care providers managing resistant hypertension must begin with comprehensive patient reassessment rather than assuming previous evaluations were thorough or accurate. Dr Cohen emphasizes the importance of taking detailed histories regardless of prior documentation, ensuring that apparent treatment resistance isn’t actually due to medication nonadherence, lifestyle factors, or secondary causes that weren’t previously identified. This systematic approach prevents inappropriate medication escalation and ensures that patients receive appropriate care for their actual clinical situation.

The addition of endothelin dual pathway antagonism and aldosterone antagonist therapy represents 2 evidence-based approaches for patients with genuine resistant hypertension who have failed standard 3-drug combinations. These therapeutic options provide health care providers with effective tools for achieving blood pressure control in patients who previously had limited treatment options. The availability of these advanced therapies has transformed the outlook for patients with resistant hypertension from frustration to realistic hope for cardiovascular protection.

Successful resistant hypertension management requires integration of advanced pharmacological therapies with comprehensive lifestyle interventions and ongoing patient support. Health care providers must maintain focus on fundamental aspects of hypertension care including dietary sodium reduction, weight management, and exercise programs while incorporating newer therapeutic options. This comprehensive approach addresses both the immediate need for blood pressure control and the long-term cardiovascular health goals that drive resistant hypertension treatment efforts.