Treatment-Resistant Hypertension Market Is Projected To Grow At A CAGR Of 6.30% By 2034, Companies: Idorsia, Janssen Biotech, Quantum Genomics, Cincor Pharma, Ionis Pharmaceuticals, Vifor Pharma, KBP

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"Treatment-Resistant Hypertension market"Treatment-Resistant Hypertension market size in the 7MM was valued at approximately USD 6,958 million in 2025. Over the forecast period from 2025 to 2034.

Therapies for Treatment-Resistant Hypertension, including Baxdrostat (CIN-107), Lorundrostat (MLS-101), TRYVIO/JERAYGO (aprocitentan), and others, are anticipated to drive growth in the Treatment-Resistant Hypertension market in the coming years.

DelveInsight has released a comprehensive report titled "Treatment-Resistant Hypertension - Market Insights, Epidemiology, and Market Forecast-2034,” providing detailed insights into the condition, historical and projected epidemiology, and market trends across the United States, EU5 (Germany, Spain, Italy, France, and the United Kingdom), and Japan.

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Some of the key facts of the Treatment-Resistant Hypertension Market Report:

• In March 2024, the U.S. Food and Drug Administration (FDA) approved Tryvio (aprocitentan), representing a notable advancement in managing resistant hypertension-a condition affecting around 20% of individuals with high blood pressure, where blood pressure remains elevated despite multiple antihypertensive therapies.

• In 2024, the United States accounted for the largest share of the Treatment-Resistant Hypertension (TRH) market among the seven major markets (7MM), with an estimated value of approximately USD 6,210 million, projected to grow further by 2034. Within the 7MM, Calcium Channel Blockers (CCBs) held the highest market value in 2024, generating roughly USD 2,110 million.

• Idorsia Pharmaceuticals is actively seeking global partnerships to expand its market presence, though a previously planned exclusivity agreement for global rights to aprocitentan was unsuccessful. The company has resumed discussions with potential partners.

• Key competitors in the TRH space include AstraZeneca (baxdrostat), Mineralys Therapeutics (lorundrostat), E-Star BioTech (MANP), Ionis Pharmaceuticals and Kardiga (tonlamarsen), Regeneron Pharmaceuticals (REGN5381), and Alnylam Pharmaceuticals in collaboration with Roche (zilebesiran).

• Several TRH therapies in development utilize varied mechanisms of action, including aldosterone synthase inhibitors (baxdrostat, lorundrostat), Guanylyl Cyclase A (GC-A) receptor activators (MANP), Natriuretic Peptide Receptor 1 (NPR1) agonists (REGN5381), angiotensinogen expression inhibitors (zilebesiran), and agents targeting angiotensinogen (tonlamarsen). Successful development of these candidates could broaden treatment options and intensify market competition.

• In 2024, the United States recorded approximately 7,365,300 diagnosed TRH cases, with prevalence expected to rise between 2025 and 2034. In Japan, females represented slightly more than half of diagnosed cases (~55%) in 2024, a proportion projected to increase by 2034.

• Major companies working on TRH therapies, including Idorsia Ltd, Janssen Biotech, Quantum Genomics SA, CinCor Pharma, Ionis Pharmaceuticals, Vifor Pharma, and KBP Biosciences, are actively developing new drugs to enhance treatment outcomes. Promising therapies include Baxdrostat (CIN-107), Lorundrostat (MLS-101), TRYVIO/JERAYGO (aprocitentan), among others.

Treatment-Resistant Hypertension Overview

Resistant hypertension (RHT) is characterized by blood pressure that remains above 130/80 mmHg despite treatment with three or four antihypertensive drugs, including a thiazide diuretic, all at the maximum tolerated doses. It also includes patients whose blood pressure is controlled only with four or more medications. Individuals whose blood pressure remains uncontrolled despite adequate therapy may have RHT or refractory hypertension. Even those with controlled blood pressure on multiple drugs may benefit from specialist assessment to exclude pseudo-resistance or secondary causes and to optimize therapy while avoiding overtreatment.

Blood pressure regulation is a complex process involving the Renin–Angiotensin–Aldosterone System (RAAS), Sympathetic Nervous System (SNS), endothelin system, natriuretic peptides, vascular function, and the immune system. Hypertension can arise from dysfunction in any of these systems, influenced by genetics, lifestyle factors-such as high salt intake, low potassium, sleep apnea, alcohol consumption, physical inactivity, stress-and aging.

Hypertension is often asymptomatic and requires regular monitoring. Extremely high blood pressure (≥180/120 mmHg) can cause headaches, chest pain, dizziness, vision disturbances, and irregular heartbeats. If left untreated, it significantly raises the risk of severe complications, including heart disease, stroke, and kidney damage.

Treatment-Resistant Hypertension Market Outlook

Resistant hypertension can damage blood vessels, increasing the likelihood of cardiovascular events. Older adults (65 years and above), individuals with obesity, and those with conditions such as diabetes, chronic kidney disease (CKD), or left ventricular hypertrophy often face greater difficulty in managing their blood pressure. Compared with patients whose blood pressure is well-controlled, those with resistant hypertension show higher rates of diabetes (48% vs. 30%), CKD (45% vs. 24%), ischemic heart disease (41% vs. 22%), and stroke (16% vs. 9%).

Managing resistant hypertension involves lifestyle interventions-such as achieving and maintaining a healthy weight through regular exercise and a balanced diet, reducing salt intake, limiting alcohol consumption, and quitting smoking-along with pharmacological treatment and, if needed, interventional procedures. Medications usually include a combination of a renin–angiotensin system blocker, a long-acting calcium channel blocker, and a diuretic at the highest tolerated doses, ideally in a single-pill formulation. Spironolactone is currently the preferred fourth-line therapy, with alternatives including alpha-blockers, beta-blockers, centrally acting sympatholytics, or vasodilators. If these strategies do not achieve adequate blood pressure control, interventional options such as renal denervation or emerging therapeutic drugs may be considered.

Lifestyle modifications play a crucial role in managing resistant hypertension. A recent meta-analysis identified lifestyle interventions as the most effective non-drug approach, lowering systolic blood pressure by an average of 7.26 mmHg. Diets such as the DASH diet-which emphasizes whole grains, fruits, vegetables, low-fat dairy, and limits saturated fats and sugars-and the Mediterranean diet have demonstrated notable benefits. Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist (nsMRA), represents a promising alternative by inhibiting aldosterone's effects irrespective of its levels. While spironolactone remains the preferred therapy, its anti-androgenic side effects restrict use in men, and treatment options are limited for patients who are intolerant or develop hyperkalemia.

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Treatment-Resistant Hypertension Marketed Drug

• TRYVIO/JERAYGO (aprocitentan): Idorsia Pharmaceutical

Treatment-Resistant Hypertension Emerging Drugs

• Baxdrostat (CIN-107): AstraZeneca

• Lorundrostat (MLS-101): Mineralys Therapeutics

Scope of the Treatment-Resistant Hypertension Market Report

• Study Period: 2020-2034

• Coverage: 7MM [The United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom), and Japan]

• Key Treatment-Resistant Hypertension Companies: Idorsia Ltd, Janssen Biotech, Quantum Genomics SA, CinCor Pharma, Ionis Pharmaceuticals, Vifor Pharma, KBP Biosciences, and others

• Key Treatment-Resistant Hypertension Therapies: Baxdrostat (CIN-107), Lorundrostat (MLS-101), TRYVIO/JERAYGO (aprocitentan), and others

• Treatment-Resistant Hypertension Therapeutic Assessment: Treatment-Resistant Hypertension current marketed and Treatment-Resistant Hypertension emerging therapies

• Treatment-Resistant Hypertension Market Dynamics: Treatment-Resistant Hypertension market drivers and Treatment-Resistant Hypertension market barriers

• Competitive Intelligence Analysis: SWOT analysis, PESTLE analysis, Porter's five forces, BCG Matrix, Market entry strategies

• Treatment-Resistant Hypertension Unmet Needs, KOL's views, Analyst's views, Treatment-Resistant Hypertension Market Access and Reimbursement

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Key benefits of the Treatment-Resistant Hypertension Market Report:

Treatment-Resistant Hypertension market report covers a descriptive overview and comprehensive insight of the Treatment-Resistant Hypertension Epidemiology and Treatment-Resistant Hypertension market in the 7MM (the United States, EU5 (Germany, Spain, France, Italy, UK) & Japan).

The Treatment-Resistant Hypertension market report provides insights into the current and emerging therapies.

The Treatment-Resistant Hypertension market report provides a global historical and forecasted market covering drug outreach in 7MM.

The Treatment-Resistant Hypertension market report offers an edge that will help in developing business strategies by understanding trends shaping and driving the Treatment-Resistant Hypertension market.

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Table of Contents

1. Report Introduction

2. Executive Summary

3. SWOT analysis

4. Treatment-Resistant Hypertension Patient Share (%) Overview at a Glance

5. Treatment-Resistant Hypertension Market Overview at a Glance

6. Treatment-Resistant Hypertension Disease Background and Overview

7. Treatment-Resistant Hypertension Epidemiology and Patient Population

8. Country-Specific Patient Population of Treatment-Resistant Hypertension

9. Treatment-Resistant Hypertension Current Treatment and Medical Practices

10. Unmet Needs

11. Treatment-Resistant Hypertension Emerging Therapies

12. Treatment-Resistant Hypertension Market Outlook

13. Country-Wise Treatment-Resistant Hypertension Market Analysis (2020–2034)

14. Market Access and Reimbursement of Therapies

15. Market drivers

16. Market barriers

17. Appendix

18. Treatment-Resistant Hypertension Report Methodology

19. DelveInsight Capabilities

20. Disclaimer

21. About DelveInsight

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About DelveInsight

DelveInsight is a leading Business Consultant and Market Research firm focused exclusively on life sciences. It supports Pharma companies by providing comprehensive end-to-end solutions to improve their performance.

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