A promising new drug may finally bring hope to people suffering from a common but often overlooked cause of high blood pressure.
An international team of researchers led by Professor Morris Brown at Queen Mary University of London has found that the drug Baxdrostat significantly lowers blood pressure in patients with a hormone-driven condition called primary aldosteronism.
Primary aldosteronism occurs when the adrenal glands produce too much of the hormone aldosterone, which helps regulate salt and potassium levels in the body.
While aldosterone was useful in early human history when salt was scarce, today’s high-salt diets mean that excess aldosterone can cause the body to hold on to too much sodium.
This leads to high blood pressure, often resistant to standard treatment.
It’s estimated that this condition may cause 1 in 10 cases of hypertension, yet it remains underdiagnosed, with fewer than 1 in 100 affected people being tested for it.
Baxdrostat, developed by AstraZeneca, belongs to a new class of drugs called aldosterone synthase inhibitors, which work by blocking the production of aldosterone at its source in the adrenal glands.
In the SPARK Phase 2a clinical trial, 15 patients with confirmed primary aldosteronism and high blood pressure that was not controlled by other medications were given Baxdrostat over a period of 72 weeks. Doses were gradually increased during the study, and patients were closely monitored.
The results were striking. On average, patients’ blood pressure dropped by 25 mmHg—two to three times more than what is usually seen with standard blood pressure medications.
The drug also helped normalize potassium levels, which are often too low in people with this condition, and reduced aldosterone levels by about 90%. It was well tolerated at all but the highest dose.
In a surprising and hopeful twist, some patients maintained normal blood pressure and hormone levels even after stopping the medication.
This raises the possibility that Baxdrostat may not just treat symptoms but could actually reset the body’s hormone system and offer a lasting cure. Until now, the only way to potentially cure primary aldosteronism was through surgery or a targeted thermal therapy procedure.
Experts believe these early findings could change how doctors manage patients with hard-to-treat blood pressure. Professor Brown hopes that the availability of a safe, effective drug will encourage more testing for primary aldosteronism, especially in people with resistant hypertension or unusual potassium or sodium levels.
Larger clinical trials are now underway to confirm these results and to determine whether the long-term benefits seen in the SPARK trial can be replicated.
If successful, Baxdrostat and similar drugs could receive approval within the next two to three years, offering new hope to millions living with high blood pressure caused by this hormone imbalance.
