- High blood pressure affects 1.3 billion people globally, raising health risks
- Baxdrostat is a new drug that lowers blood pressure by targeting aldosterone hormone
- The BaxHTN trial showed a 9-10 mmHg systolic drop after 12 weeks of baxdrostat use
High blood pressure, or hypertension, is a condition that occurs when the force of blood pushing against the walls of your blood vessels is too high. When you have high high blood pressure, it can lead to heart attack, heart disease, stroke and kidney disease, among others. High BP affects nearly 1.3 billion people across the world, including millions of people in India. For most people, the standard treatments are medicines which relax blood vessels or remove extra water, along with lifestyle and dietary changes. However, for some people these medicines don't work well enough, leaving blood pressure dangerously high. This increases the risk of heart attacks, strokes, kidney problems, and early death.
Scientists have now developed a new drug called baxdrostat, which offers hope by lowering blood pressure in these tough cases where other medicines fail. This simple pill targets a key hormone in the body that causes salt and water buildup, which pushes up blood pressure. Recent large trials show it can drop blood pressure by 9-10 mmHg or more, helping many patients reach healthy levels
The BaxHTN trial was led by Professor Bryan Williams (UCL Institute of Cardiovascular Science) and funded by AstraZeneca. It tested a new drug called baxdrostat on nearly 800 patients across 214 clinics around the world. The findings were published in the New England Journal of Medicine.
Study Results
The BaxHTN Phase III trial tested baxdrostat on nearly 800 patients across 214 clinics worldwide, including those already on multiple blood pressure drugs. After 12 weeks of taking 1 mg or 2 mg daily, patients saw their systolic blood pressure (the top number) fall by about 9-10 mmHg more than the placebo group. Around 40% reached target levels under 130/80 mmHg, compared to under 20% on placebo.
Another trial, Bax24, showed even stronger effects on 24-hour blood pressure monitoring, with a 14 mmHg reduction versus placebo. These results lasted up to 32 weeks with good safety and no major side effects reported.
Professor Williams, Principal Investigator of the study, said, "Achieving a nearly 10 mmHg reduction in systolic blood pressure with baxdrostat in the BaxHTN Phase III trial is exciting, as this level of reduction is linked to substantially lower risk of heart attack, stroke, heart failure and kidney disease."
How It Works
Baxdrostat blocks aldosterone synthase, the enzyme that makes aldosterone in the adrenal glands. Aldosterone is a hormone that tells kidneys to hold onto salt and water, increasing blood volume and pressure. In resistant hypertension, too much aldosterone often plays a big role, but earlier drugs to block it had issues like increasing potassium levels.
Unlike older treatments, baxdrostat targets this enzyme without affecting nearby ones, reducing aldosterone safely. This new approach fixes the root cause in many hard-to-treat patients, where standard drugs fall short.
Professor Williams said, "These findings are an important advance in treatment and in our understanding of the cause of difficult to control blood pressure.
"Around half of people treated for hypertension do not have it controlled, however this is a conservative estimate and the number is likely higher, especially as the target blood pressure we try to reach is now much lower than it was previously.
"In patients with uncontrolled or resistant hypertension, the addition of baxdrostat 1mg or 2mg once daily to background antihypertensive therapy led to clinically meaningful reductions in systolic blood pressure, which persisted up to 32 weeks with no unanticipated safety findings.
"This suggests that aldosterone is playing an important role in causing difficult to control blood pressure in millions of patients and offers hope for more effective treatment in the future."
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