Adding the novel medication baxdrostat to standard care may help manage high blood pressure and delay the progression of kidney disease in people with chronic kidney disease and uncontrolled high blood pressure, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2025.
This study was simultaneously published in the Journal of the American Society of Nephrology.
Chronic kidney disease and high blood pressure are closely linked and, when not managed appropriately, can lead to serious outcomes such as heart attack, stroke, heart failure and progression to kidney failure. Aldosterone, a hormone produced by the adrenal glands, can play a role in both high blood pressure and chronic kidney disease.
Aldosterone causes sodium to be retained, which increases water retention and blood pressure. Over time, an excess of the hormone can lead to stiffening and thickening of blood vessels, which can contribute to heart damage and cause scarring in the kidneys.
“These findings are encouraging for people living with chronic kidney disease and high blood pressure, two conditions that often go hand-in-hand and create a dangerous cycle,” said lead study author Jamie P. Dwyer, M.D., a professor of medicine in the division of nephrology and hypertension at University of Utah Health in Salt Lake City.
The study was designed to test whether adding baxdrostat to standard care could safely lower blood pressure in patients with serious chronic kidney disease and uncontrolled hypertension.
These patients already took ACE inhibitors or ARBs. Participants had an average systolic blood pressure of 151 mm Hg, and average urine albumin levels of 714 mg/gm, both indicative of serious health concerns. Their average estimated glomerular filtration rate (eGFR) was 44 mL/min/1.73.
Of 195 participants, 192 were randomized to low-dose, high-dose, or placebo groups. After 26 weeks:
Systolic blood pressure fell 8.1 mm Hg more in the baxdrostat group than in placebo.
41% of patients on baxdrostat had elevated potassium levels versus 5% in the placebo group.
Serious adverse events occurred in 9% of baxdrostat patients, compared to 3% in the placebo group.
Urinary albumin levels were 55% lower in those on baxdrostat.
“The reduction in urine albumin gives us hope that baxdrostat may also help delay kidney damage,” Dwyer said.
Jordana B. Cohen, M.D., M.S.C.E., of the University of Pennsylvania, commented that these results are reassuring and show promise for broad use of this medication class.
The study involved 195 patients (32% women, 40% non-Hispanic white, 80% with Type 2 diabetes) across 71 U.S. sites. Baxdrostat is not yet FDA-approved but belongs to a class of drugs that inhibit aldosterone production and are being studied for hypertension, kidney disease, and heart failure.
Funding was provided by AstraZeneca. As a preliminary abstract, the results are not yet peer-reviewed.
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