Managing Treatment-Resistant Hypertension with Baxdrostat
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on October 27th, 2025
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Elevated aldosterone level is associated with uncontrolled or treatmen-resistant hypertension. Baxdrostat is an aldosterone synthase inhibitor that has extensive biological functions due to the long half-life of 30 hours. The medication can reduce aldosterone level, which reduces sodium and water retention that causes the high blood pressure. With funding from AstraZeneca, a study was conducted to investigate the usage of baxdrostat in hard-to-treat hypertension cases.
The phase 3 clinical study included 794 individuals with an average age of around 60 years old who had been diagnosed with hypertension that is uncontrolled despite treatment with maximally tolerated doses of at least two antihypertensive medications. The cohort average systolic and diastolic pressure at baseline was 149 and 87 mmHg, respectively. The participants were randomly assigned to be treated with either placebo or baxdrostat, at a daily dose of 1 or 2 mg.
After 12 weeks of treatment, the researchers found that patients treated with baxdrostat experienced an average 15 mmHg reduction in seated systolic blood pressure, which is significantly more than the 6 mmHg reduction in those treated with placebo. The clinical benefit of baxdrostat is consistent with patients whose condition was unmanagable when treated with 2 antihypertnesive agents (uncontrolled hypertension) or 3 medications (resistant hypertension). Participants treated with baxdrostat reported a higher frequency of hyperkalemia and hyponatremia.
The phase 3 clinical study included 794 individuals with an average age of around 60 years old who had been diagnosed with hypertension that is uncontrolled despite treatment with maximally tolerated doses of at least two antihypertensive medications. The cohort average systolic and diastolic pressure at baseline was 149 and 87 mmHg, respectively. The participants were randomly assigned to be treated with either placebo or baxdrostat, at a daily dose of 1 or 2 mg.
After 12 weeks of treatment, the researchers found that patients treated with baxdrostat experienced an average 15 mmHg reduction in seated systolic blood pressure, which is significantly more than the 6 mmHg reduction in those treated with placebo. The clinical benefit of baxdrostat is consistent with patients whose condition was unmanagable when treated with 2 antihypertnesive agents (uncontrolled hypertension) or 3 medications (resistant hypertension). Participants treated with baxdrostat reported a higher frequency of hyperkalemia and hyponatremia.