A new blood pressure medicine called lorundrostat is showing real promise for people who struggle to control their high blood pressure.
A recent clinical trial shared at the American College of Cardiology’s Annual Scientific Session (ACC.25) found that this new drug could lower blood pressure in people whose condition has not been managed well with current medications.
High blood pressure, or hypertension, is a major cause of heart attacks, strokes, and heart failure. In the U.S., more than two out of three people with high blood pressure don’t have it under control. Some don’t get treatment, while others find that the medicines they take don’t work well enough.
Lorundrostat is part of a new group of medications called aldosterone synthase inhibitors, or ASIs. Most blood pressure drugs block aldosterone after it’s made, but lorundrostat stops the body from making too much of this hormone in the first place. Aldosterone makes the body hold on to salt and water, which raises blood pressure.
In the ADVANCE-HTN Phase 2b trial, researchers tested lorundrostat on 285 people from 103 locations across the U.S. These participants were already taking two to five different blood pressure medications, but their blood pressure was still high.
The average age of participants was 60, and 40% were women. Over half were Black, which is important because Black Americans often face higher rates of uncontrolled hypertension and are not always well represented in clinical trials.
The study began with all participants taking the same basic blood pressure treatments for three weeks. After that, the people whose blood pressure was still high were randomly placed into three groups.
One group got a placebo (a pill with no medicine), the second group got 50 mg of lorundrostat daily, and the third group started with 50 mg, with the option to increase to 100 mg after four weeks.
After 12 weeks, the results were clear. The 50 mg group had their 24-hour average blood pressure drop by 15.4 mm Hg, and the 50–100 mg group saw a 13.9 mm Hg drop. The placebo group only had a 7.4 mm Hg drop. That means lorundrostat lowered blood pressure by about 7 to 8 mm Hg more than the placebo.
Even better, 42% of people in the lorundrostat group had their blood pressure under control by week 4, compared to just 19% of the placebo group. The drug worked equally well across different racial groups.
Dr. Luke Laffin from the Cleveland Clinic, who led the study, said the drug lowered blood pressure effectively and was generally well tolerated. The main side effects were similar to other drugs that affect aldosterone, such as slightly higher potassium levels and some changes in kidney function. Overall, though, most people handled the medicine well.
This trial was funded by Mineralys Therapeutics, the company developing lorundrostat. A larger study is already underway to learn more about the drug’s safety and long-term effects.
For people with high blood pressure that hasn’t improved with current medicines, this new drug could be a big help. Lorundrostat works differently from most existing treatments and could offer new hope—especially for groups like Black Americans, who are at higher risk of complications from hypertension.
If future studies confirm these results, lorundrostat might soon become a valuable new option to help people get their blood pressure under control and lower their chances of strokes, heart attacks, and other serious health problems.
If you care about blood pressure, please read studies about common blood pressure medication that may extend your healthy life span and common high blood pressure drug linked to sudden cardiac arrest.
For more about blood pressure, please read studies that timing matters when taking high blood pressure pills and 1 in 5 people with high blood pressure taking a drug worsen the disease.
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