Selective endothelin receptor blockade in resistant hypertension: results of the DORADO trial

Effective treatment of resistant hypertension still remains an unmet goal of antihypertensive drug treatment. The DORADO trial recently evaluated the efficacy and safety profile of the selective endothelin receptor blocker darusentan in almost 400 hypertensive patients treated with more than four antihypertensive drugs (including a diuretic) but without effective blood pressure control. The trial results show that > 50% of patients treated with the drug exhibit clinical blood pressure < 140/90 mmHg and well-controlled ambulatory blood pressure values. Darusentan, however, was associated with a high incidence of peripheral edema and fluid retention, a side effect that may reduce the safety profile of the drug and its tolerability. Although these data are promising, the drug requires further evaluation, with particularly regard to the long term. © 2010 Informa UK, Ltd.