A new blood pressure medication called lorundrostat has shown promising results in reducing blood pressure among patients whose hypertension is not well controlled, according to a recent clinical trial.
The findings were presented at the American College of Cardiology’s Annual Scientific Session (ACC.25) and offer hope for people who have struggled to manage their high blood pressure with existing medications.
High blood pressure, also known as hypertension, is a leading cause of heart attacks, strokes, and heart failure. In the U.S., more than two-thirds of people with hypertension do not have their condition under control. This can be due to a lack of treatment or because current medications are not effective for them.
Lorundrostat is part of a new class of drugs called aldosterone synthase inhibitors (ASIs). Unlike most blood pressure medications that block the hormone aldosterone from attaching to receptors, lorundrostat works earlier in the process by reducing the production of aldosterone altogether. Aldosterone can cause the body to retain salt and water, leading to increased blood pressure.
The ADVANCE-HTN Phase 2b trial tested lorundrostat in 285 patients from 103 sites across the U.S. All participants had uncontrolled high blood pressure, even though they were already taking two to five different blood pressure medications.
The study group had an average age of 60, and 40% were women. Importantly, more than half (53%) were Black—an important step forward, as Black Americans are often underrepresented in clinical trials but are more likely to suffer from treatment-resistant hypertension.
The study began with a three-week preparation phase where all participants were given a standard set of blood pressure medications.
After this phase, those who still had high blood pressure were randomly assigned to one of three groups: one group received a placebo, the second group received 50 mg of lorundrostat daily, and the third group received 50 mg with the option to increase to 100 mg after four weeks if needed.
By 12 weeks, the results showed that lorundrostat significantly lowered blood pressure. People in the 50 mg group saw a drop of 15.4 mm Hg in their average 24-hour blood pressure, while the 50–100 mg group saw a drop of 13.9 mm Hg.
In contrast, the placebo group only had a 7.4 mm Hg drop. Compared to the placebo, lorundrostat reduced blood pressure by 7.9 mm Hg and 6.5 mm Hg in the two treatment groups, respectively.
Notably, by week 4, 42% of those taking lorundrostat had their blood pressure under control, compared to just 19% in the placebo group.
The trial also showed no differences in effectiveness between racial groups, suggesting that lorundrostat may work well across diverse populations.
According to Dr. Luke Laffin, a cardiologist at the Cleveland Clinic and the study’s lead author, “Lorundrostat effectively lowered blood pressure with an acceptable side effect profile,” adding that it could become a useful tool in treating high blood pressure and preventing serious health problems like strokes and heart attacks.
In terms of side effects, the most common ones were consistent with other drugs that affect aldosterone. Some patients experienced higher potassium levels and a decrease in kidney function, measured by a drop in glomerular filtration rate (GFR). Still, the drug was considered well tolerated overall.
The study was funded by Mineralys Therapeutics, the developer of lorundrostat. A larger, pivotal trial of the drug is already underway, with results expected later this year.
This study offers hopeful news for people with difficult-to-treat hypertension. Lorundrostat targets a different part of the blood pressure regulation system than most current medications, which may help patients who haven’t responded to standard therapies.
The inclusion of a large number of Black participants also makes the results more relevant to real-world populations who often face higher risks and fewer treatment successes.
While more research is needed to confirm long-term safety and effectiveness, the findings suggest that lorundrostat could be a valuable addition to the treatment toolbox. If future trials continue to show strong results, this drug may help more people achieve better blood pressure control—and reduce their risk of life-threatening cardiovascular events.
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The research findings can be found in The Lancet.
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