A new experimental drug has delivered encouraging results for people with dangerously high blood pressure that remains uncontrolled even after taking several medications.
Scientists say the treatment could become an important new option for millions of patients around the world living with treatment-resistant hypertension.
The findings come from a large international clinical trial called BaxHTN. The study tested a new tablet called baxdrostat and found that it significantly lowered blood pressure in people who had struggled to control their condition using existing treatments.
The research was led by Professor Bryan Williams from University College London’s Institute of Cardiovascular Science. Nearly 800 patients took part in the study at 214 medical clinics around the world.
The results were presented at the European Society of Cardiology Congress 2025 in Madrid and published in the New England Journal of Medicine.
High blood pressure, also known as hypertension, is one of the most common health conditions worldwide. Around 1.3 billion people are affected globally. Hypertension happens when the force of blood pushing against the walls of the arteries stays too high for too long.
Many people do not realize they have high blood pressure because the condition often causes no obvious symptoms in the early stages. However, over time, uncontrolled hypertension can quietly damage blood vessels and major organs throughout the body.
High blood pressure greatly increases the risk of heart attacks, strokes, heart failure, kidney disease, and early death. Because of this, doctors often call hypertension a “silent killer.”
Although there are many blood pressure medications available today, controlling hypertension remains difficult for a large number of people. Researchers estimate that about half of all patients with hypertension do not reach healthy blood pressure targets, even when taking standard treatments.
In the United Kingdom alone, around 14 million people live with hypertension. Similar problems exist in many countries worldwide, especially as populations age and unhealthy diets, obesity, and stress become more common.
Some patients develop what doctors call resistant hypertension. This means their blood pressure remains too high even after using multiple medications together. Resistant hypertension is especially dangerous because these patients face much higher risks of serious complications.
The new drug baxdrostat works differently from many older blood pressure medications. It targets a hormone called aldosterone.
Aldosterone helps control how the body balances salt and water. In healthy amounts, the hormone is important for maintaining blood pressure and fluid balance.
However, some people produce too much aldosterone, causing the body to hold onto extra salt and water. This increases blood volume and drives blood pressure higher.
Excess aldosterone can make hypertension especially difficult to treat with standard medications.
For decades, scientists have tried to develop safer and more effective ways to block this hormone pathway. Earlier treatments had limited success or caused unwanted side effects. Baxdrostat appears to offer a more direct and targeted approach by reducing the body’s production of aldosterone.
In the BaxHTN trial, patients received either baxdrostat or a placebo tablet in addition to their existing blood pressure medications. Participants taking 1 or 2 milligrams of baxdrostat once daily experienced major improvements.
After 12 weeks, their systolic blood pressure — the top number in a blood pressure reading — dropped by around 9 to 10 mmHg more than patients taking the placebo.
Doctors consider this level of blood pressure reduction medically important. Even relatively small decreases in systolic blood pressure can greatly lower the risk of heart disease and stroke over time.
The study also showed that about 40% of patients taking baxdrostat reached healthy blood pressure targets. In comparison, fewer than 20% of patients in the placebo group achieved those targets.
Professor Williams described the results as an exciting advance in hypertension treatment. He explained that reductions of this size could significantly reduce the risk of heart attacks, strokes, kidney disease, and other complications linked to uncontrolled blood pressure.
Another encouraging finding was that the benefits continued for up to 32 weeks during follow-up. Researchers also reported no unexpected safety problems during the trial.
Scientists believe resistant hypertension may actually be more common than official estimates suggest. In recent years, many medical organizations have lowered the recommended target levels for healthy blood pressure, meaning even more people may now be classified as having poorly controlled hypertension.
Professor Williams said the drug could potentially help as many as half a billion people worldwide. In the UK alone, he believes up to 10 million people might benefit if future studies continue to show positive results.
The findings are especially important because hypertension rates are rising rapidly in many lower-income and Asian countries. More than half of all global hypertension cases are now found in these regions.
Because high blood pressure is one of the leading causes of preventable death worldwide, better treatments could have enormous public health benefits.
Researchers caution that baxdrostat is still an experimental drug and further studies will be needed before it becomes widely available. However, the results suggest the medication may represent one of the most promising advances in blood pressure treatment in many years.
If future trials confirm the benefits and safety of the drug, baxdrostat could become an important new tool for helping patients whose blood pressure has remained dangerously high despite existing therapies.
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