American College of Cardiology/American Heart Association (ACC/AHA) guidelines for treatment of hypertension were last published in 2018. Treatment of hypertensive urgencies and emergencies is not discussed here.

The FDA has approved the dual endothelin receptor antagonist aprocitentan (Tryvio – Idorsia) for use in combination with other antihypertensive drugs to treat hypertension in adults whose blood pressure is not adequately controlled on other drugs. Three other dual endothelin receptor antagonists, ambrisentan (Volibris, and generics), bosentan (Tracleer, and generics), and macitentan (Opsumit), are available in the US for treatment of pulmonary arterial hypertension.

The once-monthly, subcutaneously injected calcitonin gene-related peptide (CGRP) receptor antagonist erenumab-aooe (Aimovig) was approved by the FDA in 2018 for preventive treatment of migraine in adults. Now the FDA has added a new warning to its labeling about a risk of new-onset hypertension and worsening of preexisting hypertension associated with use of the drug. CGRP is a potent microvascular vasodilator; blocking or deleting it has produced hypertensive effects in animals.

The FDA has approved sotatercept-csrk (Winrevair – Merck), a first-in-class activin signaling inhibitor, to increase exercise capacity, improve WHO functional class, and reduce the risk of clinical worsening events in adults with WHO Group 1 pulmonary arterial hypertension (PAH).

The FDA has approved iDose TR (Glaukos), an intracameral implant containing the prostaglandin analog (PGA) travoprost, for reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. Travoprost is also available as a topical ophthalmic solution (Travatan Z, and generics) for the same indication. iDose TR is the second ocular implant to become available in the US for this indication; Durysta, an intracameral implant containing the prostaglandin analog bimatoprost, was the first.

Our recent article on Drugs for Hypertension (Med Lett Drugs Ther 2024; 66:81) described both the Paradise and Symplicity Spyral renal denervation devices as ultrasound devices. That is true for the Paradise device, but Symplicity Spyral uses radiofrequency ablation.

Fruquintinib (Fruzaqla – Takeda), an oral kinase inhibitor, has been approved by the FDA for treatment of adults with metastatic colorectal cancer (mCRC) who received prior fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, anti-VEGF therapy, and, in patients with RAS wild-type mutations, anti-EGFR therapy. The drug can be used in patients with mCRC regardless of biomarker status. Fruquintinib is the first drug to become available in the US for treatment of mCRC that targets 3 VEGF receptor kinases.

Topical minoxidil (Rogaine, and others), which is available over the counter, has been used for treatment of hair loss in men and women for more than 30 years. Recently published trials suggest that off-label use of a low dose of oral minoxidil may also be effective.

The FDA has approved an intracameral implant containing the prostaglandin analog bimatoprost (Durysta – Allergan) for reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension. Bimatoprost is also available in 0.01% (Lumigan) and 0.03% (generics) ophthalmic solutions for the same indication and in a 0.03% solution (Latisse, and generics) for eyelash enhancement. Durysta is the first ocular implant to become available in the US for treatment of glaucoma.

The FDA has approved zavegepant nasal spray (Zavzpret – Pfizer) for acute treatment of migraine with or without aura in adults. Zavzpret is the first nasal spray formulation of a calcitonin gene-related peptide (CGRP) receptor antagonist ("gepant") to become available in the US.