A Phase III clinical trial has demonstrated that a new medication, baxdrostat, can significantly reduce blood pressure in individuals with treatment-resistant hypertension. Led by Professor Bryan Williams from University College London (UCL) and sponsored by AstraZeneca, the international BaxHTN trial involved nearly 800 participants across 214 clinics worldwide.
Hypertension affects approximately 1.3 billion people globally, with around half of these cases remaining uncontrolled despite treatment. This condition increases the risk of serious health issues, including heart attacks and strokes. In the UK, an estimated 14 million people are affected by high blood pressure.
The trial results, presented at the European Society of Cardiology Congress 2025 and published in the New England Journal of Medicine, revealed that patients taking baxdrostat (1 mg or 2 mg daily) achieved a reduction in systolic blood pressure of about 9-10 mmHg compared to those receiving a placebo. This reduction is significant enough to lower cardiovascular risk, with approximately 40% of patients on baxdrostat reaching healthy blood pressure levels, compared to less than 20% on placebo.
Baxdrostat functions by inhibiting the production of aldosterone, a hormone that influences blood pressure regulation by affecting salt and water retention in the kidneys. The trial's findings suggest that this medication could offer a new avenue for treating millions of patients who struggle to control their hypertension.
Professor Williams emphasized the importance of these results, noting that they indicate a substantial advance in both treatment and understanding of difficult-to-control hypertension. The findings suggest that baxdrostat could potentially benefit up to half a billion individuals worldwide, including around 10 million in the UK, in light of updated blood pressure management guidelines.