Key result
Baxdrostat lowers office SBP by ~10 mmHg vs placebo in uncontrolled hypertension.
Why the study?
Despite several available antihypertensive agents, optimal blood pressure control remains difficult to achieve in many patients.
Does baxdrostat reduce blood pressure in adults with inadequately controlled hypertension?
RCT (n=794)
Double-blind
Randomized
Yes
Does baxdrostat reduce blood pressure in adults with inadequately controlled hypertension?
Mean Difference: -9.8 (95% CI -12.6–-7)
Absolute Event Rate: -15.7% vs -5.8%
p-value: p=< 0.0001
Baxdrostat, a first-in-class aldosterone synthase inhibitor, offers a new therapeutic option for reducing blood pressure in adults with inadequately controlled hypertension.
Baxdrostat may add an option for resistant hypertension; leaves open long-term outcomes and real-world adoption.
Hypertension is a chronic cardiovascular disorder characterized by persistently elevated arterial blood pressure, typically defined as a systolic blood pressure (SBP) ≥140 mm Hg and/or a diastolic blood pressure (DBP) ≥90 mm Hg on repeated measurements. Although there are several antihypertensive agents available, optimal blood pressure control is difficult to achieve in many patients. Baxdrostat (Baxfendy) is a first-in-class oral aldosterone synthase inhibitor that is indicated for the treatment of hypertension in adults whose blood pressure is inadequately controlled despite treatment with other antihypertensive agents. It selectively inhibits CYP11B2, thereby reducing aldosterone synthesis without affecting cortisol production. Phase III clinical trials demonstrated significant reductions in SBP and DBP with once-daily administration and an acceptable safety profile. Hyperkalemia and hyponatremia were the most frequently reported adverse effects. This review highlights the pharmacological profile, clinical efficacy, safety profile, and therapeutic role of baxdrostat in the management of hypertension.
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Nair et al. (2026) conducted an RCT in Hypertension (n=794). Baxdrostat vs. Placebo was evaluated on Change from baseline to Week 12 in seated office systolic blood pressure (MD -9.8, 95% CI -12.6, -7.0, p=< 0.0001). Baxdrostat 2 mg once daily significantly reduced seated office systolic blood pressure by a mean difference of 9.8 mmHg compared to placebo at 12 weeks in patients with uncontrolled hypertension.
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