A new once-daily pill, baxdrostat, has shown “spectacular” results in lowering high blood pressure, offering hope to millions who struggle with the condition despite existing treatments. Developed by AstraZeneca, the drug targets a core mechanism responsible for hypertension and may benefit up to 10 million people in the United Kingdom and as many as half a billion worldwide.
In clinical trials, patients taking baxdrostat experienced reductions in blood pressure of 9 to 10 mmHg within 12 weeks. Researchers note that this decrease is significant enough to lower the risk of heart disease, stroke, and other related complications. Around 40 percent of patients taking the drug achieved healthy blood pressure levels, compared to fewer than 20 percent in the placebo group.
How Baxdrostat Works?
Baxdrostat works by blocking an enzyme that produces aldosterone, a hormone discovered in 1952 that regulates both blood pressure and salt content in the body. High levels of aldosterone have been linked to cases of hypertension that are difficult to control with current medications.
Professor Bryan Williams, chair of medicine at University College London and lead investigator of the global BaxHTN trial, explained that reducing aldosterone to normal levels is key to effective management. “By getting the aldosterone level down with these drugs, we’ve seen blood pressure come down spectacularly,” he said.
Unlike older medications that influence aldosterone indirectly, baxdrostat prevents the hormone’s production at its source. This approach, researchers believe, could reduce the need for multiple drugs while providing more consistent results.
The Global Trial and Its Impact
The BaxHTN trial involved nearly 800 patients across 214 clinics worldwide. Participants included individuals whose blood pressure remained high despite standard treatments. After three months, the drug not only demonstrated substantial reductions in average readings but also improved overall control rates among patients with resistant hypertension.
High blood pressure affects an estimated 14 million people in the UK and 1.3 billion worldwide. It is often symptomless but significantly increases the risk of heart attacks, strokes, kidney disease, and dementia. Experts describe it as the most important preventable cause of premature death.
Prof. Williams emphasized the broader significance of the findings: “For years, the sense was that we already had enough drugs for treating high blood pressure. But what we now know is that current medications are not achieving the control rates we need. It’s exciting to see a therapy that targets the underlying mechanism.”
Looking Ahead
AstraZeneca plans to submit baxdrostat to medical regulators later this year, with hopes of making it available for widespread use in the near future. If approved, it would represent the first new class of hypertension drugs in years, at a time when the condition remains one of the world’s most persistent health challenges.
By tackling aldosterone directly, researchers believe baxdrostat could transform treatment for patients who do not respond adequately to existing therapies. It may also reduce the overall number of drugs required, making hypertension management simpler and more effective.
“Because we are targeting the underlying problem, which we haven’t been doing with the drugs that we currently use, we can achieve much better control,” Prof. Williams noted.
As the global burden of high blood pressure continues to rise, experts see baxdrostat as a promising development in preventing the serious health consequences associated with the condition. If regulatory approval follows, millions could benefit from a daily pill that finally addresses the root cause of hard-to-control hypertension.
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