Health and Me

Ishita Roy

Do We Now Have A Shot For Blood Pressure? here's What You Should Know

A new review published in The Lancet highlights how close this shift may be. The study underscores a hard truth: despite having effective medicines for years, global <span>blood pressure</span> control remains disappointingly poor. The real challenge, experts say, is not the absence of drugs—but problems with adherence, health systems, and long-term patient engagement.

<h2>The Unrelenting Burden of a Silent Killer</h2>

Hypertension continues to be the leading cause of heart attacks, strokes and premature deaths worldwide. The World Health Organization (WHO) defines high blood pressure as readings at or above 140 mm Hg systolic and/or 90 mm Hg diastolic. A normal reading is below 120/80 mm Hg.

The numbers are staggering. Between 2024 and 2025, an estimated 1.4 billion adults aged 30 to 79—roughly one in three people in this age group—are living with hypertension globally. Nearly 44 percent do not even know they have it. Among those diagnosed, fewer than one in four have their blood pressure adequately controlled.

India reflects this alarming trend. The ICMR-INDIAB study (2023) estimated that about 315 million Indians—35.5 percent of the population—have hypertension. Data from NFHS-5 further showed that nearly half of hypertensive men and more than a third of hypertensive women in India do not have their condition under control.

<h2>Why Daily Pills Are Falling Short</h2>

For decades, hypertension treatment has relied on daily oral medications—often combinations of two or more drugs. These may include ACE inhibitors, angiotensin receptor blockers paired with calcium channel blockers, and thiazide diuretics.

On paper, these regimens are effective. In reality, adherence is the weak link.

Many patients with hypertension also manage diabetes, obesity or high cholesterol. The result is polypharmacy—multiple pills, multiple times a day. Over time, missed doses, side effects and simple “treatment fatigue” erode consistency. Therapeutic inertia—where doctors do not intensify treatment despite poor control—further worsens outcomes.

<h2>The Rise of Long-Acting Injectables</h2>

This is where long-acting injectable therapies come in. According to Dr Mohit Gupta, cardiologist at G B Pant Hospital and UCMS, the field is now moving toward therapies that may be administered just twice a year.

Unlike traditional medicines that work downstream to reduce blood pressure numbers, these new drugs target upstream molecular pathways that drive hypertension.

One promising approach involves small interfering RNA (siRNA) therapies that inhibit angiotensinogen production in the liver. By silencing this protein, they dampen the renin–angiotensin system—central to blood pressure regulation. Zilebesiran, developed by Roche and Alnylam, is currently in global phase 3 trials.

Another candidate, ziltivekimab by Novo Nordisk, targets inflammatory pathways increasingly linked to cardiovascular risk. There are also newer strategies aimed at selectively modulating aldosterone, a hormone that increases blood volume and pressure.

The appeal is simple: durability. A twice-yearly injection could eliminate the daily burden of pill-taking, improve adherence and provide more stable blood pressure control over time.

However, excitement is tempered by concern. Cost remains a major question. The recent introduction of inclisiran, an injectable cholesterol-lowering therapy priced between Rs 1.8 and 2.4 lakh annually in India, highlights affordability challenges.

Long-term safety is another critical issue. Hypertension is lifelong. Patients may require these treatments for decades. Experts stress the need for robust long-term data across diverse populations before widespread adoption.

The promise is undeniable. A twice-yearly injection that reliably controls blood pressure could transform preventive cardiology. But its true impact will depend not only on scientific success—but on accessibility, affordability and sustained safety.

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A new review published in The Lancet highlights how close this shift may be. The study underscores a hard truth: despite having effective medicines for years, global blood pressure control remains disappointingly poor. The real challenge, experts say, is not the absence of drugs—but problems with adherence, health systems, and long-term patient engagement.The Unrelenting Burden of a Silent KillerHypertension continues to be the leading cause of heart attacks, strokes and premature deaths worldwide. The World Health Organization (WHO) defines high blood pressure as readings at or above 140 mm Hg systolic and/or 90 mm Hg diastolic. A normal reading is below 120/80 mm Hg.The numbers are staggering. Between 2024 and 2025, an estimated 1.4 billion adults aged 30 to 79—roughly one in three people in this age group—are living with hypertension globally. Nearly 44 percent do not even know they have it. Among those diagnosed, fewer than one in four have their blood pressure adequately controlled.India reflects this alarming trend. The ICMR-INDIAB study (2023) estimated that about 315 million Indians—35.5 percent of the population—have hypertension. Data from NFHS-5 further showed that nearly half of hypertensive men and more than a third of hypertensive women in India do not have their condition under control.Why Daily Pills Are Falling ShortFor decades, hypertension treatment has relied on daily oral medications—often combinations of two or more drugs. These may include ACE inhibitors, angiotensin receptor blockers paired with calcium channel blockers, and thiazide diuretics.On paper, these regimens are effective. In reality, adherence is the weak link.Many patients with hypertension also manage diabetes, obesity or high cholesterol. The result is polypharmacy—multiple pills, multiple times a day. Over time, missed doses, side effects and simple “treatment fatigue” erode consistency. Therapeutic inertia—where doctors do not intensify treatment despite poor control—further worsens outcomes.The Rise of Long-Acting InjectablesThis is where long-acting injectable therapies come in. According to Dr Mohit Gupta, cardiologist at G B Pant Hospital and UCMS, the field is now moving toward therapies that may be administered just twice a year.Unlike traditional medicines that work downstream to reduce blood pressure numbers, these new drugs target upstream molecular pathways that drive hypertension.One promising approach involves small interfering RNA (siRNA) therapies that inhibit angiotensinogen production in the liver. By silencing this protein, they dampen the renin–angiotensin system—central to blood pressure regulation. Zilebesiran, developed by Roche and Alnylam, is currently in global phase 3 trials.Another candidate, ziltivekimab by Novo Nordisk, targets inflammatory pathways increasingly linked to cardiovascular risk. There are also newer strategies aimed at selectively modulating aldosterone, a hormone that increases blood volume and pressure.The appeal is simple: durability. A twice-yearly injection could eliminate the daily burden of pill-taking, improve adherence and provide more stable blood pressure control over time.Promise, But With CautionHowever, excitement is tempered by concern. Cost remains a major question. The recent introduction of inclisiran, an injectable cholesterol-lowering therapy priced between Rs 1.8 and 2.4 lakh annually in India, highlights affordability challenges.Long-term safety is another critical issue. Hypertension is lifelong. Patients may require these treatments for decades. Experts stress the need for robust long-term data across diverse populations before widespread adoption.The promise is undeniable. A twice-yearly injection that reliably controls blood pressure could transform preventive cardiology. But its true impact will depend not only on scientific success—but on accessibility, affordability and sustained safety.