Revolution in hypertension treatment, only two injections per year

A pill every day for decades or two injections a year… is this the new breakthrough of science for people suffering from hypertension, writes salute.eu.

It’s not science fiction. It’s zilebesiran, and the results of the KARDIA-2 study published in JAMA on July 1, 2025 have just changed what we thought we knew about hypertension.

Hypertension affects 1 in 3 adults worldwide. The problem is not diagnosis. The problem is that almost no one manages to take medication every day for decades. It is forgotten, stopped, and restarted. Meanwhile, the risk of heart attack and stroke increases.

Researchers have known for years: the weak point of therapy is not the drug, but adherence to taking it.

Zilebesiran has been tested precisely in this direction: in patients who no longer respond to standard oral therapy. The most difficult cases. Those in whom pills have already failed.

A single injection under the skin. The effects were measured after three months: systolic pressure dropped by up to 12.1 mmHg compared to placebo, consistently, without peaks, without gaps between doses. After six months, the reduction was still ongoing.

How does it work?

This is where the mechanism comes in, and it’s worth understanding. Zilebesiran does not act like a classic blood pressure drug. It uses RNA interference (RNAi) technology to directly “silence” the angiotensinogen gene in the liver.

It does not block the gene’s final product. It stops production at the source, before the system that regulates blood pressure is activated.

Spoiler: the silenced gene does not reactivate for months. This is why one injection every six months is enough.

In the study, patients treated with zilebesiran needed fewer additional medications compared to those who received placebo.

The safety profile was encouraging: changes in laboratory tests were mild and disappeared within one or two weeks. No one discontinued the study due to side effects.

For now, the drug is still in development. But the direction is clear. Two injections a year make it possible to cover medication adherence for all 365 days of the year.

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