A new drug has been found to significantly lower blood pressure in people with dangerously high levels despite taking several existing medicines, an advance that could help address hard-to-treat hypertension cases.
Around half of the global 1.3 billion high blood pressure cases are treatment-resistant, with such patients facing a much greater risk of heart attack, stroke, kidney disease, and early death.
Now, researchers have shown that a new pill, baxdrostat, can make patients’ blood pressure fall large enough to cut heart disease risk.
The phase III clinical trial, involving participation from nearly 800 patients across 214 clinics worldwide, found that after 12 weeks, patients taking baxdrostat in pill form – 1 mg or 2 mg once daily – saw their blood pressure fall by around 9-10 mmHg more than placebo.
Tyler Williams, who currently doesn’t have dental insurance, has his blood pressure checked at a Remote Area Medical (RAM) mobile dental and medical clinic at Terre Haute South High School on August 02, 2025 in Terre Haute, Indiana (Getty Images)
Researchers noticed that about 4 in 10 patients reached healthy blood pressure levels, compared with fewer than 2 in 10 on placebo.
“Achieving a nearly 10 mmHg reduction in systolic blood pressure with baxdrostat in the BaxHTN Phase III trial is exciting, as this level of reduction is linked to substantially lower risk of heart attack, stroke, heart failure and kidney disease,” said Bryan Williams, a co-author of the study from University College London.
“In patients with uncontrolled or resistant hypertension, the addition of baxdrostat 1mg or 2mg once daily to background antihypertensive therapy led to clinically meaningful reductions in systolic blood pressure, which persisted up to 32 weeks with no unanticipated safety findings,” Dr Williams said.
The findings also reveal the role played by a key hormone in specific cases of difficult-to-control blood pressure in millions of patients.
“These findings are an important advance in treatment and in our understanding of the cause of difficult-to-control blood pressure,” Dr Williams said.
In our bodies, a hormone called aldosterone manages blood pressure by helping the kidneys regulate salt and water balance.
In some people, too much aldosterone is produced, causing the body to hold onto salt and water and pushing blood pressure up.
Achieving a balance in this hormone’s level using drugs has been a challenge for decades.
The new drug baxdrostat works by blocking aldosterone production and directly addressing this regulator of high blood pressure.
“Around half of people treated for hypertension do not have it controlled; however, this is a conservative estimate, especially as the target blood pressure we try to reach is now much lower than it was previously,” Dr Williams said.
“The results suggest that this drug could potentially help up to half a billion people globally – and as many as 10 million people in the UK alone, especially at the new target level for optimal blood pressure control,” he said.