Daily Pill Might Help People With Stubborn High Blood Pressure

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An experimental pill might help people with stubborn high blood pressure that won’t relent to other treatments, clinical trial results show.

Patients with treatment-resistant high blood pressure saw a significant drop after taking the new drug baxdrostat once a day for three months, researchers reported Aug. 30 in the New England Journal of Medicine.

Blood pressure fell by 9 to 10 mm/Hg in those taking baxdrostat, results show.

“This level of reduction is linked to substantially lower risk of heart attack, stroke, heart failure and kidney disease,” senior researcher Dr. Bryan Williams, chair of medicine at University College London, said in a news release.

About 4 out of 10 baxdrostat patients achieved a healthy blood pressure, compared to fewer than 2 in 10 given a placebo tablet, researchers found.

Baxdrostat works by blocking the body’s production of aldosterone, a hormone that helps the kidneys regulate salt and water balance.

Some people produce too much aldosterone, causing their bodies to hold onto salt and water. This pushes blood pressure up and makes it hard to keep at a healthy level, researchers said.

“Around half of people treated for hypertension do not have it controlled,” Williams said. “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.”

For the clinical trial, researchers randomly assigned a group of nearly 800 people to take baxdrostat daily in a 1 milligram or 2 milligram dose, or to take a placebo pill.

The patients all had systolic blood pressure between 140 and 170, even though they’d been taking two or more blood pressure medications, the study said.

Results showed that the drug effectively reduced people’s treatment-resistant blood pressure.

“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,” Williams said.

Based on these results, pharma company AstraZeneca is preparing to file for baxdrostat’s approval with the U.S. Food and Drug Administration (FDA), the firm said in a news release.

The clinical trial data “demonstrate baxdrostat’s potential in tackling one of the toughest challenges in cardiovascular care, which is hypertension that is hard to control despite multiple therapies,” said Sharon Barr, executive vice president of biopharmaceuticals R&D at AstraZeneca.

“We look forward to advancing our regulatory filings for baxdrostat with health authorities in the months ahead,” she added in a news release.

AstraZeneca funded the clinical trial.

More information

The American Heart Association has more on blood pressure medications.

SOURCES: University College London, news release, Aug. 30, 2025; AstraZeneca, news release, Aug. 30, 2025 

Source: HealthDay

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