A growing worldwide health concern is hypertension, which is defined by European criteria as an office systolic blood pressure (SBP) of ≥140 mmHg and/or diastolic blood pressure (DBP) of ≥90 mmHg (Mancia et al., 2007). Globally, 1.13 billion individuals are projected to be affected, and by 2025, this number is expected to rise by 15%–20%. Over 60% of those aged 60 and older have hypertension, which is a major cause of CVD and early mortality globally (Berry et al., 2012). The incidence of hypertension rises with age. In addition to being frequently linked to obesity, diabetes mellitus, and chronic kidney disease (CKD), all of which raise the risk of CVD, hypertension also causes damage to arteries and other end organs on its own (Kearney et al., 2005). Therefore, limiting end-organ damage and hence lowering CVD mortality and morbidity are the objectives of antihypertensive therapy. Meta-analyses show that a 20% decrease in the relative risk of all major CVD events may be achieved with a 10-mmHg drop in SBP or a 5-mmHg reduction in DBP (Hunter et al., 2021; Thomopoulos et al., 2014).

The majority of oral cardiovascular medications are tiny molecules that diffuse through the cell membranes to show their action. Therapeutic antibodies for CVD have been licensed recently. These include proprotein convertase subtilisin/kexin type-9 (PCSK-9) and angiopoietin-like 3 (ANGPTL3), which is intended for certain individuals with lipid disorders. However, obstacles to broad usage include the expenses and labor involved in the creation and development of antibodies as well as the requirement for regular parenteral administration. Targeting ribonucleic acid (RNA), nucleic acid-based therapeutics provide a novel strategy that may be possible to get beyond a number of the previously described obstacles. The category of RNA-targeted treatments includes RNAi through the use of siRNA, a concept acknowledged with the Nobel Prize in Physiology or antisense oligonucleotide (ASO) technology (Bennett et al., 2017).

This novel class of drugs is revolutionary because it can target and inhibit any disease-related protein, including pathways that were previously believed to be “undruggable." It can also be manufactured very easily and affordably. This important new class of drugs has the potential to fundamentally alter how we treat and prevent cardiovascular disease. Several medications that target different therapeutic regions are presently under development, and several of these treatments have already received approval in Europe and the United States.