Kidney enzyme as a new target for treatment of high blood pressure, study reveals

ENPEP is an integral part of the hormonal system within the body that is essential for regulation of blood pressure. This means the enzyme is an attractive target for developing new medications to treat high blood pressure.

It had been believed reducing levels of ENPEP in the brain could lower blood pressure. However, a recent clinical trial which tested a new drug called Firibastat, the FRESH study, failed to show a significant reduction in blood pressure in patients with hypertension.

The Manchester-led research team instead found that increasing levels of ENPEP in the kidney could have the desired effect of lowering blood pressure.

Study Principal Investigator and Integrative Cardiovascular Medicine Theme Co-Lead at Manchester BRC, Professor Maciej Tomaszewski, announced the results at the European Society of Cardiology (ESC) Congress in Amsterdam on Sunday 27 August 2023, as part of the Basic and Translational Late-Breaking Science session.

Professor Tomaszewski, who is also Chair of Cardiovascular Medicine at The University of Manchester, and an Honorary Consultant Physician at Manchester University NHS Foundation Trust, said: “We need more choices of blood pressure lowering medications for our hypertensive patients. Whilst we have several classes of effective medications available, the last new medication approved for management of high blood pressure in the UK and many other countries was direct renin inhibitor (aliskiren), and this was approximately 15 years ago. In contrast, patients with other complex cardiometabolic conditions, such as diabetes or coronary artery disease, continue benefiting from new excellent life-saving drugs constantly entering the therapeutic arena.

“Our results show that through a robust connection to blood pressure emerging from our study and a high ‘druggability’ potential (its ability to be therapeutically modulated by medicines), kidney ENPEP is a new promising target for development of new blood pressure lowering medications.”