New Drug Shows Promise in Treating Resistant High Blood Pressure

A groundbreaking clinical trial has revealed that a novel medication significantly reduces high blood pressure in patients who have not responded to existing treatments. Conducted by researchers at University College London (UCL), this Phase III trial focused on the drug baxdrostat, which targets hormonal imbalances contributing to resistant hypertension.

High blood pressure, or hypertension, affects approximately 1.3 billion individuals worldwide, with nearly half of these cases being resistant to conventional therapies. This condition increases the risk of serious health complications, including heart attacks, strokes, kidney disease, and premature death. In the UK alone, around 14 million people are living with hypertension.

The international BaxHTN trial, led by Professor Bryan Williams from the UCL Institute of Cardiovascular Science, involved nearly 800 participants across 214 clinics globally. The results were presented at the European Society of Cardiology (ESC) Congress 2025 in Madrid and published in the New England Journal of Medicine.

After 12 weeks of treatment, patients receiving baxdrostat (either 1 mg or 2 mg daily) experienced a decrease in blood pressure by approximately 9-10 mmHg compared to those on a placebo. Notably, around 40% of baxdrostat users achieved healthy blood pressure levels, in stark contrast to fewer than 20% in the placebo group.

Professor Williams emphasized the significance of these findings, noting that a 10 mmHg reduction in systolic blood pressure is associated with a considerably lower risk of cardiovascular events, including heart attacks and strokes. This reduction could prove vital for the nearly half of patients who struggle to manage their hypertension effectively.

The mechanism behind baxdrostat involves its ability to inhibit the production of aldosterone, a hormone that plays a critical role in regulating salt and water balance in the body. In some individuals, excessive aldosterone production leads to water retention and elevated blood pressure, making management of hypertension particularly challenging.

Addressing this hormonal imbalance has been a focus of medical research for many years, and the success of baxdrostat represents a significant breakthrough in treatment options. Professor Williams remarked that the addition of baxdrostat to standard antihypertensive therapies resulted in lasting reductions in blood pressure, maintaining efficacy for up to 32 weeks without unexpected safety concerns.

The prevalence of hypertension has shifted over the years, with significant numbers of patients now found in lower-income and Eastern countries, contrary to earlier trends where higher-income nations reported more cases. Over half of those affected by hypertension reside in Asia, with countries like China and India housing millions of individuals dealing with this condition.

According to the findings, baxdrostat could potentially benefit up to 500 million people globally, including around 10 million individuals in the UK who are striving for better blood pressure management.