New Medication Could Help Millions With High Blood Pressure

A new injection, given twice a year, may revolutionize blood pressure treatment and prevent major cardiovascular events.

New research from Queen Mary University of London, published in JAMA, reveals that a simple injection every six months could significantly lower blood pressure in people struggling to control the condition.

The international study, known as KARDIA-2, enrolled 663 participants whose high blood pressure was not adequately managed with standard treatments. In the trial, patients received an injection of a new medication called zilebesiran in addition to their usual medications.

Patients who received zilebesiran saw greater reductions in their blood pressure compared to those who continued with standard therapy alone.

This breakthrough could be life-changing for the millions affected by high blood pressure, a condition that impacts about one in three adults in the UK. Left untreated, high blood pressure can dramatically increase the risk of serious health problems such as heart attacks, strokes, and even death.

Results from a clinical trial led by researchers from Queen Mary University of London, published today in JAMA, show that giving people with high blood pressure an injection every six months can lead to a meaningful, sustained reduction in their blood pressure.

The global trial, KARDIA-2, involved 663 people with high blood pressure whose condition wasn’t being well managed with their standard treatment.

In the trial, patients were given an injection of a new medication zilebesiran, alongside their standard blood pressure treatments. Researchers found that giving patients zilebesiran alongside their standard medication was better at reducing their blood pressure levels than standard medication alone.

The results could have a big positive impact for those with high blood pressure, which affects around 1 in 3 adults in the UK and, if left untreated, increases the risk of cardiovascular events such as heart attacks, strokes, and even death.

Expert Insights on the Clinical Trial

Dr Manish Saxena, Clinical Co-Director of the William Harvey Clinical Research Centre at Queen Mary University of London and a hypertension specialist at Barts Health NHS Trust was the lead investigator for the study in the UK and senior author on the new publication.

Speaking on the results, he said: “Hypertension is a global health concern as blood pressure control rates remain poor and is a leading cause of heart attacks and strokes. This study demonstrates the efficacy and safety of zilebesiran, when added to commonly used first-line blood pressure-lowering drugs. The novelty of this treatment is its long duration; giving just one injection every six months could help millions of patients to better manage their condition.”

How Zilebesiran Works

Zilebesiran is an investigational therapeutic that uses RNA interference technology. It blocks the production of a specific protein in the liver (angiotensinogen), helping blood vessels to relax and lowering blood pressure. The injection is given under the skin.

The next steps for zilebesiran involve another Phase 2 study, KARDIA-3, to see if this treatment has the potential to be used to treat people with high blood pressure and established cardiovascular disease, or those at high risk of cardiovascular disease.

Later this year, the sponsor plans to enrol patients in a big global outcomes study to understand its effect on reducing cardiovascular events, strokes, and cardiovascular death.

Reference: “Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension: The KARDIA-2 Randomized Clinical Trial” by Akshay S. Desai, Adam D. Karns, Jolita Badariene, et al, 28 May 2025, JAMA.
DOI: 10.1001/jama.2025.6681

The study was funded by Alnylam Pharmaceuticals, with Barts Health NHS Trust serving as a lead site for the trial and top European enroller on the study.

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