High blood pressure is a major health problem around the world. It affects about 1.3 billion people.
In many cases, even with treatment, blood pressure stays too high. This condition is called treatment-resistant or uncontrolled high blood pressure.
People with this problem are more likely to suffer heart attacks, strokes, kidney failure, and early death. In the UK alone, around 14 million people live with high blood pressure.
Now, there is new hope. A new medicine called baxdrostat has shown powerful results in people whose blood pressure stays high despite taking several other medicines. This new treatment was tested in an international study called the BaxHTN trial.
The research was led by Professor Bryan Williams from University College London (UCL), and it included nearly 800 patients from 214 clinics around the world. The study was sponsored by AstraZeneca and supported by the UK’s National Institute for Health and Care Research.
The results were shared on August 30th at a major heart health meeting in Madrid and published in the New England Journal of Medicine.
After 12 weeks of taking baxdrostat once a day, patients saw their blood pressure drop by 9 to 10 mmHg more than those who took a placebo (a pill with no medicine). This is a big drop and can lower the risk of serious health events.
Around 40% of people taking the drug reached healthy blood pressure levels. For comparison, fewer than 20% of those taking the placebo reached healthy levels.
Professor Williams said this is an exciting finding. A drop of nearly 10 mmHg in blood pressure is linked to much lower chances of heart attacks, strokes, heart failure, and kidney problems.
Baxdrostat works in a new way. It targets a hormone in the body called aldosterone. This hormone helps control how the kidneys handle salt and water. But in some people, the body makes too much aldosterone.
This makes the body hold on to too much salt and water, which raises blood pressure. Until now, scientists have struggled to create a medicine that safely stops this from happening.
Baxdrostat blocks the body’s ability to make too much aldosterone. That makes it easier to lower blood pressure that has been hard to control.
Professor Williams explained that many people with high blood pressure still don’t have it under control, and this number may be even higher than we think.
The good news from the trial is that people who added baxdrostat to their regular blood pressure medicine saw a strong and lasting drop in their blood pressure—up to 32 weeks—without serious side effects.
This means aldosterone may play a much bigger role in tough-to-treat high blood pressure than we previously thought. And now, we may have a way to treat it.
Professor Williams also pointed out a major shift. In the past, high blood pressure was more common in rich Western countries. But today, due to changing diets and lifestyle factors, it’s now more common in lower-income countries, especially in Asia.
Over half of all people with high blood pressure live in Asia—more than 200 million in China and nearly 200 million in India.
This new drug could help as many as half a billion people around the world, and around 10 million in the UK alone. Baxdrostat offers real hope for better treatment and better lives for people with hard-to-treat high blood pressure.
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