New Drug May Lower Blood Pressure In Hard-to-Treat Patients
The experimental drug baxdrostat may help hypertension patients who can’t sufficiently reduce their blood pressure with other medications.
Canva
Some people with uncontrolled high blood pressure who can’t manage the condition effectively with typical multidrug treatment regimens might one day achieve this goal with a single pill, a new study suggests.
The early-stage study included 248 people with what’s known as treatment-resistant hypertension, who had unhealthy blood pressure levels despite taking at least three different medications to manage the condition. Participants were randomly assigned to take either a placebo or a 0.5-, 1-, or 2-milligram (mg) dose of the experimental drug baxdrostat.
After 12 weeks of treatment, patients on the highest baxdrostat dose saw their systolic blood pressure — the “top number” that shows how much pressure blood exerts against artery walls when the heart beats — drop by an average of 20 points, according to study results published in the The New England Journal of Medicine.
“The results of this first-of-its-kind drug are exciting, although more testing is required before we can draw comparisons with any existing medications,” co-senior study author Morris Brown, MD, a professor of endocrine hypertension at Queen Mary University of London, said in a statement.
“But baxdrostat could potentially offer hope to many people who do not respond to traditional hypertension treatment,” Dr. Brown added.
Baxdrostat also worked at lower doses, although with less dramatic results. Systolic blood pressure declined by an average of 17.5 points with the 1 mg dose and by about 12 points on average with the 0.5 mg dose.
At the start of the study, most patients had average systolic blood pressure levels over 140 millimeters of mercury (mmHg), which is classified as stage 2 hypertension by the American Heart Association (AHA). Doctors often prescribe a combination of several different blood pressure medications and lifestyle changes like improved eating and exercise habits.
By the end, many of the patients on baxdrostat reduced their systolic blood pressure levels enough to be classified with either stage 1 hypertension — a range from 130 mmHg to 139 mmHg.
A total of 44 percent of patients in the study experienced side effects, most of which were mild. The most common side effects, occurring in at least 5 percent of patients, were urinary tract infections, elevated potassium levels, headache, and fatigue. Eight patients experienced serious side effects, including dangerously low blood pressure, abnormally low sodium levels, and unusually high potassium levels.
Baxdrostat works by preventing the body from making aldosterone, a hormone that can cause salt to be retained in the body, driving up blood pressure. Patients with excessive aldosterone levels in the blood are resistant to treatment with the commonly used drugs for hypertension. Baxdrostat suppressed blood and urine levels of aldosterone.
The study results were from the second of three phases of clinical trials typically required for U.S. regulatory approval. CinCor Pharma supported the trial and employed several researchers involved in the study.