A new medication called baxdrostat is giving fresh hope to people with dangerously high blood pressure that remains uncontrolled even after taking several different medicines.
In a major international clinical trial, researchers found that the drug significantly lowered blood pressure in patients whose hypertension had been difficult to treat for years.
The findings were presented at the European Society of Cardiology Congress 2025 in Madrid and published in the New England Journal of Medicine. Scientists believe the drug could eventually help millions of people worldwide who are at high risk of heart attacks, strokes, kidney disease, and early death because of uncontrolled blood pressure.
High blood pressure, also known as hypertension, is one of the most common health conditions in the world. It affects around 1.3 billion people globally.
Doctors often call hypertension a “silent killer” because many people do not realize they have it until serious damage has already happened. Over time, high blood pressure places extra strain on the heart and blood vessels, increasing the risk of severe health problems.
Although many people take medicine for hypertension, blood pressure often remains too high. Experts estimate that about half of all cases worldwide are either uncontrolled or resistant to treatment.
In resistant hypertension, patients continue to have high blood pressure even after taking several medications at the same time. This creates a major challenge for doctors and patients.
The new study, called BaxHTN, was led by Professor Bryan Williams from the UCL Institute of Cardiovascular Science. The research was supported by AstraZeneca and the NIHR Biomedical Research Centre at University College London Hospitals.
Nearly 800 patients joined the trial across 214 clinics around the world. Participants were given either baxdrostat or a placebo pill for comparison. Researchers tested two doses of the new drug, 1 milligram and 2 milligrams taken once daily.
After 12 weeks of treatment, the results were very encouraging. Patients taking baxdrostat experienced blood pressure reductions of around 9 to 10 mmHg more than people taking the placebo.
Doctors consider this to be a major improvement because even small reductions in blood pressure can significantly lower the risk of heart disease and strokes.
The study also showed that about 40% of patients taking baxdrostat reached healthy blood pressure levels, compared with fewer than 20% of people in the placebo group. According to Professor Williams, this level of improvement could greatly reduce the risk of future health complications for many patients.
Researchers believe the success of baxdrostat comes from the way it targets a hormone called aldosterone. Aldosterone is produced by the adrenal glands and helps control the body’s balance of salt and water.
In some people, the body produces too much aldosterone. This causes the kidneys to hold onto extra salt and water, which increases blood pressure and makes hypertension harder to control.
For decades, scientists have tried to find effective ways to block this harmful process. Baxdrostat works by directly stopping the production of aldosterone, helping the body release excess salt and water and lowering blood pressure more effectively.
Professor Williams described the findings as an exciting breakthrough in both treatment and scientific understanding of resistant hypertension.
He explained that current blood pressure targets are now lower than in the past because doctors better understand how dangerous even moderately high blood pressure can be. However, many patients still struggle to reach these healthier targets with existing medications.
Another important finding from the trial was that the benefits of baxdrostat continued for up to 32 weeks. Researchers also reported that there were no unexpected safety concerns during the study. This is important because safety is a major concern for patients who may need to take blood pressure medicine for many years.
The problem of hypertension is growing rapidly worldwide. In the past, high blood pressure was more common in wealthier Western countries, but today it is rising quickly in developing regions as diets and lifestyles change.
More than half of all people with hypertension now live in Asia, including around 226 million people in China and 199 million people in India.
Professor Williams said baxdrostat could eventually help up to half a billion people worldwide who struggle to control their blood pressure. In the United Kingdom alone, he estimated the drug could benefit as many as 10 million people.
Researchers are continuing to study the drug to better understand its long-term benefits and risks. Future research may also explore whether baxdrostat can reduce heart attacks, strokes, kidney disease, and deaths linked to hypertension over many years.
Doctors still recommend lifestyle changes as the first step for managing blood pressure. Eating a healthy diet, reducing salt intake, exercising regularly, avoiding smoking, limiting alcohol, managing stress, and maintaining a healthy weight can all help lower blood pressure naturally.
However, for people whose hypertension remains dangerously high despite these efforts and multiple medications, new treatments like baxdrostat may offer an important new option.
The study adds to growing research into hypertension treatments and prevention.
Other recent studies have compared common blood pressure medicines such as ARBs and ACE inhibitors, examined how blood pressure changes during exercise may predict future heart disease, explored foods that support heart health, and investigated possible side effects linked to widely used blood pressure drugs.
As scientists continue searching for better treatments, baxdrostat may represent a major step forward for patients living with one of the world’s most common and dangerous chronic diseases.
If you care about high blood pressure, please read studies that early time-restricted eating could help improve blood pressure, and natural coconut sugar could help reduce blood pressure and artery stiffness.
For more information about blood pressure, please see recent studies about How to eat your way to healthy blood pressure and results showing that Modified traditional Chinese cuisine can lower blood pressure.
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