Efficacy of aprocitentan in patients across the cardiometabolic disease spectrum including obesity to be presented at AHA Hypertension

Two oral presentations at AHA Hypertension 2026 will highlight the antihypertensive efficacy of aprocitentan in two hypertension populations from the PRECISION study: patients with obesity and patients across the cardiovascular-kidney-metabolic (CKM) continuum.

Idorsia has announced what it describes as positive findings from two new analyses of the pivotal Phase 3 PRECISION study. The analyses highlight the role of endothelin pathway blockade in patients with obesity-associated resistant hypertension and across the CKM continuum. The findings will be presented in oral sessions at the American Heart Association Hypertension Scientific Sessions 2026, taking place in Arlington, Virginia, from 7 to 11 October 2026.

Targeting the endothelin pathway in obesity and hypertension

Obesity and hypertension are closely interconnected. Hypertension is one of the most common comorbidities of obesity and a major contributor to cardiovascular and kidney damage in this population. As the prevalence of obesity rises, the number of people living with obesity-associated hypertension is expected to increase.

People with obesity are more likely to develop hypertension that remains uncontrolled despite treatment with multiple antihypertensive medicines. Upregulation of the endothelin pathway appears to be an important mechanism that had not been targeted in hypertension before aprocitentan. Adipose tissue releases endothelin-1, and greater release is seen in people with obesity, so obesity is associated with increased detrimental effects of endothelin-1.

The new analysis evaluated aprocitentan in patients with resistant hypertension and obesity or severe obesity, many of whom were also living with diabetes, chronic kidney disease or albuminuria. According to Idorsia, the findings strengthen the evidence supporting endothelin pathway blockade in this population.

The results will be presented by Dr Michael A. Weber in the session “Endothelin is a driver of hypertension in individuals with obesity: A post hoc analysis of the PRECISION study” on Saturday 10 October.

Targeting the endothelin pathway across the CKM continuum

Cardiovascular-kidney-metabolic (CKM) syndrome is defined as a health disorder attributable to the interconnections among obesity, diabetes, chronic kidney disease and cardiovascular disease. The risk of cardiovascular death nearly triples as CKM progresses from stages 0–1 to stage 4. More than 64% of the US adult population is classified as CKM stages 2 to 4.

Hypertension is a central driver across this continuum and contributes to chronic kidney disease progression. Dysfunction in the cardiovascular, kidney and metabolic systems then creates a self-reinforcing cycle that increases the risk of cardiovascular events, kidney failure, hospitalisation and premature death.

Endothelin has detrimental effects relevant to multiple components of CKM syndrome, including blood pressure regulation, kidney function and metabolic effects such as aldosterone production. This provides a rationale for examining endothelin inhibition across different stages of CKM syndrome.

The second analysis evaluated aprocitentan across early and advanced CKM stages, looking at blood pressure control and other measures relevant to cardiovascular, kidney and metabolic health. The findings will be presented by Dr John M. Flack in the session “Endothelin as a therapeutic target across the cardiovascular-kidney-metabolic continuum: A post hoc analysis of the PRECISION study.”