A phase III trial presented at the European Society of Cardiology (ESC) Congress 2025, and published in The New England Journal of Medicine looks at the drug Baxdrostat for uncontrolled or treatment resistant high blood pressure.
Professor Paul Leeson, Professor of Cardiovascular Medicine and Cardiologist, University of Oxford, said:
“Patients with uncontrolled blood pressure often struggle to find the right tablets to reduce their risk of heart attacks or strokes. When new medicines are proven to lower blood pressure without causing significant rises in unwanted side effects, these are important to know about. Increased levels in the blood of a substance called aldosterone are known to be a cause of difficult to control blood pressure. For many years, we have had medications that are able to block aldosterone working but they do not actually lower levels of aldosterone, so patients may still experience adverse effects of the substance. Baxdrostat, the medicine used in this trial, is one version of a new range of medications that work differently, and directly reduce the levels of aldosterone.
“Importantly, the trial was performed across several countries and included both men and women, as well as patients with different ethnic backgrounds. This helps ensure the findings are relevant to the range of patients we see with blood pressure problems. The reduction in blood pressure of ~5 to 10mmHg is typically what we would expect for any drug or intervention we use to manage blood pressure. The medication also worked even when added on top of other tablets. The trial did not test whether the drug reduces your chance of a heart attack or stroke, but we would expect a benefit based on how it effects the blood pressure. This new type of medicine may therefore be a potentially valuable additional treatment to tackle high blood pressure.”
‘Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension’ by John M. Flack et al. was presented at the European Society of Cardiology (ESC) Congress 2025, and simultaneously published in The New England Journal of Medicine at 15:15 UK Time Saturday 30th August 2025.
DOI: 10.1056/NEJMoa2507109
Declared interests
Professor Paul Leeson: No conflicts relevant to this study