{"id":138885,"date":"2025-08-31T14:23:25","date_gmt":"2025-08-31T18:23:25","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=138885"},"modified":"2026-01-28T15:06:57","modified_gmt":"2026-01-28T20:06:57","slug":"baxhtn-baxdrostat-significantly-reduced-blood-pressure-in-patients-with-uncontrolled-or-resistant-hypertension","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=138885","title":{"rendered":"BaxHTN: Baxdrostat Significantly Reduced Blood Pressure in Patients with Uncontrolled or Resistant Hypertension"},"content":{"rendered":"<p><b>Key Points:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Uncontrolled and resistant hypertension remains a major challenge despite treatment with multiple antihypertensive agents.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Baxdrostat, a selective aldosterone synthase inhibitor, significantly reduced systolic blood pressure (SBP) at 12 weeks compared to placebo in patients with treatment-resistant or uncontrolled hypertension.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The effect of baxdrostat was sustained across all phases of the study, with no unanticipated safety concerns.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Despite widespread use of multiple medications, many patients with hypertension fail to achieve target blood pressure (BP) levels. In particular, patients with uncontrolled or treatment-resistant hypertension face persistently elevated BP despite being on two or more antihypertensive agents, including a diuretic. Aldosterone is a known contributor to treatment resistance, but efforts to safely and selectively inhibit aldosterone synthesis have historically been unsuccessful.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The BaxHTN trial, presented in a Hot Line session at the ESC Congress 2025 and simultaneously published in the <\/span><i><span style=\"font-weight: 400;\">New England Journal of Medicine<\/span><\/i><span style=\"font-weight: 400;\">, evaluated the efficacy and safety of baxdrostat, a first-in-class selective aldosterone synthase inhibitor. The randomized phase 3 trial enrolled 796 patients at 214 sites worldwide. Eligible participants had a seated SBP between 140 and 170 mmHg despite treatment with maximally tolerated antihypertensive regimens.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In the 12-week double-blind phase (Part 1), patients were randomized 1:1:1 to receive baxdrostat 1 mg, baxdrostat 2 mg, or placebo. The mean age was 62 years, and 39% were women; 73% had resistant hypertension. At week 12, placebo-adjusted reductions in seated SBP were \u22128.7 mmHg for the 1 mg dose and \u22129.8 mmHg for the 2 mg dose (both p&lt;0.0001). Ambulatory 24-hour SBP also fell by 16.9 mmHg with the 2 mg dose, with night-time reductions of 11.7 mmHg. BP control (SBP &lt;130 mmHg) was achieved in 40% of patients on baxdrostat 2 mg versus 18.7% on placebo.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Part 2 re-randomized patients to receive baxdrostat 2 mg or standard-of-care in an open-label extension. At the end of Part 2, mean SBP was 133 mmHg. In Part 3, patients previously receiving baxdrostat 2 mg were randomized to either continue treatment or switch to placebo for eight weeks. SBP rose in the placebo group (+1.4 mmHg) but continued to decline in the baxdrostat group (\u22123.7 mmHg; p=0.0016), confirming sustained BP-lowering efficacy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Baxdrostat was generally well tolerated. Serious adverse events occurred in 1.9%, 3.4%, and 2.7% of the 1 mg, 2 mg, and placebo groups, respectively. Hyperkalemia led to treatment discontinuation in 0.8% and 1.5% of patients on baxdrostat 1 mg and 2 mg, respectively. There were no cases of adrenocortical insufficiency.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThese findings are an important advance in our understanding of hard-to-treat hypertension,\u201d said principal investigator Professor Bryan Williams (University College London). \u201cBaxdrostat achieved clinically meaningful BP reductions without unexpected safety concerns, offering new hope for patients with resistant or uncontrolled hypertension.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Funded by AstraZeneca, the BaxHTN trial supports selective aldosterone synthase inhibition as a promising new strategy for patients whose blood pressure remains uncontrolled despite conventional therapy.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Key Points: Uncontrolled and resistant hypertension remains a major challenge despite treatment with multiple antihypertensive agents. Baxdrostat, a selective aldosterone synthase inhibitor, significantly reduced systolic blood pressure (SBP) at 12 weeks compared to placebo in patients with treatment-resistant or uncontrolled hypertension. The effect of baxdrostat was sustained across all phases of the study, with no [&hellip;]<\/p>\n","protected":false},"author":40615,"featured_media":138886,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[900,8],"tags":[45,901,47,185],"ppma_author":[1069],"class_list":{"0":"post-138885","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-esc-2025","8":"category-news","9":"tag-conference","10":"tag-esc2025","11":"tag-featured","12":"tag-news","13":"author-hassan-adam-alhassan-md"},"authors":[{"term_id":1069,"user_id":40615,"is_guest":0,"slug":"hassan-adam-alhassan-md","display_name":"Hassan Adam Alhassan MD","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/8cc8318e58bf0ad1548b042cbb04e2e62466d8fe5780d7b1f138246f2c21b2b5?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138885","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40615"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=138885"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138885\/revisions"}],"predecessor-version":[{"id":138887,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138885\/revisions\/138887"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/138886"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=138885"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=138885"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=138885"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=138885"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}