A new medicine called baxdrostat has shown promising results in helping people lower their blood pressure, even when other treatments haven’t worked.
This news comes from a major international study led by Professor Bryan Williams from University College London (UCL).
The results were shared at the 2025 European Society of Cardiology Congress in Madrid and published in the New England Journal of Medicine.
High blood pressure, or hypertension, affects around 1.3 billion people worldwide. In about half of these cases, the condition is not properly controlled, even with medication. These patients face serious health risks like heart attacks, strokes, kidney failure, and early death. In the UK alone, around 14 million people have high blood pressure.
The BaxHTN trial involved nearly 800 patients from 214 clinics around the world. Participants had high blood pressure that wasn’t being controlled by standard treatments. They were given a daily tablet of either 1 mg or 2 mg of baxdrostat, or a placebo (a pill with no active drug).
After 12 weeks, those who took baxdrostat had their systolic blood pressure drop by about 9 to 10 mmHg more than those on the placebo. This is a big improvement—enough to lower the risk of serious heart problems. In fact, four in 10 patients taking baxdrostat reached healthy blood pressure levels, compared to only two in 10 on the placebo.
Professor Williams explained why this is so exciting. A drop of nearly 10 mmHg in systolic blood pressure is linked to fewer heart attacks, strokes, heart failure, and kidney problems. The drug works by blocking a hormone called aldosterone, which helps the body hold on to salt and water.
When too much aldosterone is produced, it can make blood pressure very hard to manage. By stopping the production of this hormone, baxdrostat helps reduce blood pressure in people who haven’t responded to other treatments.
Importantly, the benefits of baxdrostat continued for up to 32 weeks, and the study did not find any unexpected side effects. This makes it a safe and effective option for long-term use.
Professor Williams said this could be a game changer for millions of people worldwide. While past research has shown how aldosterone affects blood pressure, this is one of the first successful attempts to block it effectively with medication.
With new guidelines setting even lower targets for healthy blood pressure, more people than ever could benefit from this treatment.
Although hypertension used to be more common in richer Western countries, today it is more widespread in lower-income and Eastern countries. This is due to changes in diet and lifestyle. More than half of all people with high blood pressure now live in Asia, including 226 million in China and 199 million in India.
This new drug could help up to half a billion people across the globe, including as many as 10 million people in the UK. For those who have been struggling to control their blood pressure, baxdrostat could be the breakthrough they’ve been waiting for.
The study is published in New England Journal of Medicine.
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