This study is testing zilebesiran, a medication, to see if it helps people with high blood pressure (hypertension) and heart issues. The study compares zilebesiran to a placebo, which is a treatment that looks like the real one but doesn't have the active medicine. Researchers want to know if zilebesiran can lower the risk of serious heart problems like heart attacks and strokes.

To join, you need to be at least 18 years old if you already have heart disease, or 55 if you're at high risk. You should be taking at least two blood pressure medicines, one being a type of diuretic, which helps your body get rid of extra salt and water.

However, you can't join if you have certain other health issues, like secondary hypertension (a different cause for high blood pressure), liver problems, or very low kidney function.

• The study will run until a certain number of heart-related events occur.
• Participants must be on stable hypertension medication.
• Eligibility based on age and heart disease risk factors.