A new drug has shown impressive results in lowering blood pressure in people whose condition has remained dangerously high despite taking multiple existing medications.
The findings, from a large international Phase III clinical trial, could offer new hope for millions living with treatment-resistant hypertension.
High blood pressure, or hypertension, affects about 1.3 billion people worldwide.
Left untreated or poorly controlled, it raises the risk of heart attack, stroke, kidney disease, and early death.
Around half of all people with hypertension struggle to keep it under control, even with standard treatments. In the UK alone, an estimated 14 million people live with the condition.
The new trial, called BaxHTN, tested an experimental tablet called baxdrostat. Led by Professor Bryan Williams from UCL’s Institute of Cardiovascular Science, the study included nearly 800 patients at 214 clinics across the globe.
Results were presented at the European Society of Cardiology Congress 2025 in Madrid and published in the New England Journal of Medicine.
After 12 weeks of treatment, patients who took 1 or 2 milligrams of baxdrostat once a day saw their blood pressure fall by about 9 to 10 mmHg more than those given a placebo.
This level of reduction is considered medically significant, as even small decreases in systolic blood pressure are linked to a much lower risk of cardiovascular disease. Importantly, about 40% of patients taking the drug reached healthy blood pressure targets, compared with fewer than 20% in the placebo group.
Professor Williams described the findings as an “exciting advance,” noting that such reductions can lead to substantial decreases in the risk of heart attack, stroke, and kidney disease.
The drug works in a new way by targeting a hormone called aldosterone, which plays a crucial role in controlling how the body regulates salt and water.
In some people, the body produces too much aldosterone, leading to excess salt and water retention, which drives blood pressure up and makes it difficult to treat.
For decades, researchers have tried to develop medicines to block this pathway effectively, but with limited success. Baxdrostat appears to directly address this imbalance by preventing the production of aldosterone.
The trial also showed that the benefits of baxdrostat continued for up to 32 weeks, with no unexpected safety issues reported.
Williams noted that resistant hypertension is likely even more common than official figures suggest, especially as medical guidelines have lowered the target levels for optimal blood pressure in recent years. He emphasized that the new drug could potentially benefit as many as half a billion people worldwide, including up to 10 million in the UK alone.
As hypertension rates continue to rise in lower-income and Asian countries—where more than half of cases are now found—this breakthrough treatment could help reduce one of the leading causes of preventable death globally.
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