{"id":"98d2d5cab002","type":"article","url":"https://hartvaat.nl/2025/04/01/aprocitentan-bij-zwarte-patienten-met-hypertensie/","title":"Aprocitentan bij zwarte patiënten met hypertensie","title_en":"Aprocitentan for Blood Pressure Reduction in Black Patients.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","anemie-ckd","aprocitentan","bloeddrukbehandeling","endotheel","endothelineantagonisten","precision-trial","renale-denervatie","vrouwen","zwangerschap-hart"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.124.24142","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.124.24142","authors":["John M Flack","Markus P Schlaich","Michael A Weber","Mouna Sassi-Sayadi","Krzysztof Narkiewicz","Martine Clozel","Roland F Dreier","Nabil S Andrawis","Parisa Danaietash","Nashwa Gabra","David Scott","Ji-Guang Wang","Keith C Ferdinand"],"significance":6,"published":"2025-04-01","source_date":"2025-04-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/"],"congress":"","summary_en":"This subanalysis confirmed that aprocitentan effectively lowers blood pressure in Black hypertensive patients, extending the endothelin antagonist evidence to a population with disproportionate hypertension burden.","created":"2026-07-03T10:31:34Z","updated":"2026-07-03T18:39:15Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Subanalyse onderzocht het effect van aprocitentan bij zwarte hypertensieve patiënten. Het endothelineantagonisme was even effectief als bij andere etnische groepen, wat de brede toepasbaarheid bevestigt.","abstract_original":"BACKGROUND: Black individuals frequently present with resistant hypertension and disproportionately increased cardiovascular risk. We investigated the blood pressure (BP)-lowering effect of the dual endothelin receptor antagonist aprocitentan in Black individuals enrolled in the PRECISION study (Parallel-Group, Phase 3 Study with Aprocitentan in Subjects with Resistant Hypertension). METHODS: Patients with confirmed resistant hypertension were randomized to aprocitentan 12.5 mg, 25 mg, or placebo for 4 weeks (part 1). They subsequently received aprocitentan 25 mg for 32 weeks (part 2) before re-randomization to aprocitentan 25 mg or placebo (part 3). RESULTS: Eighty-two patients randomized in the PRECISION study were Black individuals. At week 4, aprocitentan 12.5 and 25 mg reduced office trough systolic BP (-11.3 and -11.9 mm Hg) to a similar degree as placebo (-12.0 mm Hg). Using 24-hour ambulatory BP monitoring, the placebo effect was minimal (-0.7 mm Hg), and aprocitentan reduced systolic BP by 4.0 and 8.6 mm Hg. During part 2, office BP continued to decrease (-16.4 mm Hg at week 36). In part 3, office and ambulatory systolic BP increased on placebo (+9.9 and +8.1 mm Hg, respectively), whereas the BP-lowering effect was maintained with aprocitentan. Aprocitentan markedly reduced albuminuria during the study. The most frequent adverse event was peripheral edema, occurring in 3 patients (10%) receiving aprocitentan 25 mg versus none receiving aprocitentan 12.5 mg or placebo. CONCLUSIONS: Aprocitentan reduced BP and albuminuria in Black individuals with resistant hypertension. The BP-lowering efficacy was similar to that of the overall PRECISION population. Aprocitentan may represent an important addition to the often difficult-to-control hypertension in Black individuals. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03541174."}