Stubborn high blood pressure drops with an experimental drug that inhibits aldosterone

An experimental, once-a-day pill called baxdrostat has been shown to significantly lower blood pressure in patients whose blood pressure remains critically high despite treatment with multiple other medications. These results came in an international Phase III trial led by Professor Bryan Williams.

This new drug — detailed in The New England Journal of Medicine — is an aldosterone synthase inhibitor. It directly blocks the production of aldosterone. High levels of aldosterone hormone is the leading cause of resistant hypertension, as it causes the body to retain excess salt and water.

The BaxHTN Phase III was a double-blind trial which enrolled about 800 patients with controlled or resistant hypertension. 12 weeks into the study, the patients who received a 2-mg daily dose of baxdrostat to their existing therapy saw their systolic blood pressure drop by an average of 15.7 mmHg. However, those who were taking a placebo saw an average drop of 5.8 mmHg. This means a statistically significant, placebo-corrected reduction of 9.8 mmHg

Achieving a nearly 10 mmHg reduction in systolic blood pressure... is exciting, as this level of reduction is linked to substantially lower risk of heart attack, stroke, heart failure and kidney disease. — Professor Williams.

The researchers found the drug to be safe, though about 3% of patients who took the drug experienced higher-than-normal potassium levels, compared to just 0.4% in the placebo group. This shows the drug has high potential to become a go-to drug for people with hypertension.

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