Posted on 09/04/2025 5:40:48 AM PDT by Red Badger
A breakthrough pill has proven to lower dangerous, treatment-resistant blood pressure, offering new hope to millions at risk of heart disease and stroke. Credit: Shutterstock A powerful new pill has been shown to bring down stubbornly high blood pressure that resists standard treatments, according to results from a landmark global trial.
The drug, baxdrostat, lowered blood pressure by nearly 10 mmHg on average — enough to slash the risk of heart attack, stroke, and kidney failure.
Breakthrough Trial Shows New Hope
Around the world, an estimated 1.3 billion people live with high blood pressure (hypertension). In roughly half of these cases, the condition remains uncontrolled or does not respond to standard treatments. This group faces a sharply increased risk of heart attack, stroke, kidney problems, and early death. In the UK alone, about 14 million people are affected.
To address this challenge, researchers launched the international BaxHTN trial, directed by Professor Bryan Williams of the UCL Institute of Cardiovascular Science and sponsored by AstraZeneca. The study tested a new oral drug, baxdrostat, with close to 800 patients taking part across 214 medical centers worldwide.
Findings from the study were shared on August 30 at the European Society of Cardiology (ESC) Congress 2025 in Madrid and published at the same time in the New England Journal of Medicine.
Powerful Results in Resistant Patients
After 12 weeks of treatment, participants who received baxdrostat (1 mg or 2 mg once daily in pill form) experienced an average reduction in blood pressure of about 9 to 10 mmHg more than those given a placebo. This decrease is significant enough to meaningfully lower cardiovascular risk. Roughly 40 percent of patients taking baxdrostat achieved healthy blood pressure levels, compared with fewer than 20 percent of those on placebo.
Professor Williams, the trial’s Principal Investigator and lead presenter at ESC, said: “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.”
How the Pill Works Inside the Body
Blood pressure is strongly influenced by a hormone called aldosterone, which helps the kidneys regulate salt and water balance.
Some people produce too much aldosterone, causing the body to hold onto salt and water. This aldosterone dysregulation pushes blood pressure up and makes it very difficult to control.
Addressing aldosterone dysregulation has been a key effort in research over many decades, but it has been so far difficult to achieve.
Baxdrostat works by blocking aldosterone production, directly addressing this driver of high blood pressure (hypertension).
An Important Step Forward in Treatment
Professor Williams, Chair of Medicine at UCL, said: “These findings are an important advance in treatment and in our understanding of the cause of difficult-to-control blood pressure.
“Around half of people treated for hypertension do not have it controlled. However, this is a conservative estimate and the number is likely higher, especially as the target blood pressure we try to reach is now much lower than it was previously.[1]
“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.
“This suggests that aldosterone is playing an important role in causing difficult-to-control blood pressure in millions of patients and offers hope for more effective treatment in the future.”
A Global Health Challenge
Historically, higher-income Western countries were reported to have far higher levels of hypertension; however, largely due to changing diets (adding less salt to food), the number of people living with the condition is now far higher in Eastern and lower-income countries. More than half of those affected live in Asia, including 226 million people in China and 199 million in India.[2]
Professor Williams added: “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.”
Notes
The ESC 2024 hypertension guidelines recommended a target blood pressure of less than 130/80 mmHg. Prior to 2024 the target had been 140/90 mmHg. Figures from Blood Pressure UK
Reference:
“Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension”
by John M. Flack, Michel Azizi, Jenifer M. Brown, Jamie P. Dwyer, Jakub Fronczek, Erika S.W. Jones, Daniel S. Olsson, Shira Perl, Hirotaka Shibata, Ji-Guang Wang, Ulrica Wilderäng, Janet Wittes and Bryan Williams, 29 August 2025, New England Journal of Medicine.
DOI: 10.1056/NEJMoa2507109
The study was supported by the NIHR Biomedical Research Centre at UCLH.
Of course, after taking this pill for an extended time period, you will begin to grow a third arm and have uncontrollable vomiting.
I do that now.......................
This is a heads up for people who do not measure their blood pressure at home.
The estimates are 25% to 33% of people measure high blood pressure in a doctor’s office and at home it is normal. There are enough people who do not measure at home at all that it is suspected that those numbers are low.
There is no better blood pressure treatment than to discover you are one of these people with what is called White coat hypertension. If so it is highly likely that no treatment is warranted. You do not spend your life in the doctor’s office. You spend the vast majority of it outside the doctor’s office and therefore the vast majority of your hours are spent with normal blood pressure and no treatment to achieve that.
Elderly with low cholesterol might very well be suspected of having this. The hardening of the arteries much spoken of requires a raw material to have that hardening take place. Cholesterol is the material and if yours is low or normal with no treatment it would be difficult to have hardening of the arteries, which is a primary mechanism in the elderly for hypertension.
Docs are very much aware of this and that’s why I single measurement of high blood pressure does not immediately trigger treatment. They will want to follow it for a while. But chances are they do so in the clinic where you are elevated.
There has been some research on this that suggests it is not an issue of nervousness or fear of doctors or things of that sort. Current speculation is there was an experience as a child that was negative and a doctor’s office and it hard wires the brain to react to that environment during your formative years. You can sit down and relax for a long time. You can tell yourself to relax and stop being afraid. But it has nothing to do with any of that. The brain triggers hypertension because it grew up that way in that environment.
Anyway, heads up. Get yourself a blood pressure monitor. They’re cheap. There is a website that will list all of the blood pressure monitors available to the public and whether they have been certified as accurate. Validatebp.org from the AMA
“Of course, after taking this pill for an extended time period, you will begin to grow a third arm and have uncontrollable vomiting.”
There’s a saying in the medical field (I used to work in): “Show me a drug that doesn’t have a lawsuit against it and I’ll show you a new drug.”
Thanks for posting.
Sounds like a statin, which I absolutely refuse to take but I don’t need it anyway.
I highly recommend staying away from statins.
-SB
“The estimates are 25% to 33% of people measure high blood pressure in a doctor’s office and at home it is normal.”
In Europe they just ASK YOU what you’re blood pressure is at home. I guess here the drug companies don’t permit that.
Anyway, for those who get more drugs than they need, and if the drugs are cheap, take what you need to have a BP you’re happy with, and just pack away the rest and and use them if you go on a long cruise or otherwise out of town for a while...rather than have to beg to get them in advance.
I regularly have abnormally high diastolic pressure; this would do nothing for me. Then it test normal a week later, so I dont know what to do.
Cholesterol does NOT cause hardening of the arteries.
Chronic Inflammation CAUSES hardening of the arteries.
I am 65, with high cholesterol since i was 25 (that’s 40 years). I get a scan every year. They grade it based on how little plaque is in my arteries. 100 is none detected, and 0 is you have all your arteries clogged (you would be dead long before that).
I am VERY careful about inflammation. I take natural anti-inflammatory supplements, and avoid inflammatory foods and exposures. Do some research about why the body produces cholesterol.
If you are on statins, that’ really bad. You should address the inflammation, which will allow your body to not plaque out even in the presence of high cholesterol.
BTW, my score is always in the 98-100 range.
Phrasing.
High cholesterol does not CAUSE hardening of the arteries. Cholesterol is the material required for hardening of the arteries.
The cells that make up the artery wall do not suddenly become hard. It is the interior of the artery that accumulates this plaque which is mostly cholesterol and a mixture of dead cells. That’s stiffens the wall and that is hardening and that elevates blood pressure.
Hypertension is a matter of time. It’s how much time the interior of your arteries are exposed to elevated pressure and have to react to it. If you have the occasional high measurement but are mostly low you’re pretty safe.
If elderly and you’re usually low, but had enough high measurements to start treatment, that gets dangerous. During one of your naturally low period of time you could get driven too low by the meds and fall down stairs from lightheadedness. This is because nearly all treatments decrease both systolic and diastolic. Getting pushed too low even one minute of a day and that minute happened to be at the the top of some stairs and you can ruin what is remaining of your life.
Docs are very much aware of this entire thing. There is danger and letting people walk around with elevated blood pressure. There is also danger in treating people who have normal blood pressure such that it becomes low.
It sounds like you do measure away from the clinic so you have recorded numbers that are not strictly at the office. Make sure you write them down and take them with you to your appointments.
I had one doctor who wanted to put me on blood pressure medicine after one reading in his office. I refused. Other than that they seem to accept my statement that it stays in normal ranges at home.
Absolutely I do. My concern is my diastolic number. Over time it has been high compared to what is normal - not always necessarily hypertension high but enough to cause me some concern. I am on medication to help, but in general most medication seems to focus on systolic numbers.
You might want to look up the graphs. It’s all statistical.
The elevation of risk for a measurement that is slightly high is also very slightly high. If you’re walking around with 150 over 100, that doesn’t mean you die tomorrow. That effect has to accumulate over a significant period of time.
If it’s brief there’s just not much risk.
There are calculators online for cardiovascular events which means heart attack or stroke. All the risk factors are on there and the conclusion is some increased percentage over the perfect body at your particular age.T
Docs don’t usually involve themselves with discretion. If the accepted recommendation is x in response to y, then you are going to hear x from them. And that’s generally the way you would want it. They’re all operating from the same instruction manual. The instruction manual changes only when research accumulates to compel it.
For your own peace of mind, take your home blood pressure monitor with you to the doctor’s office.
It will be a shock that you will very much enjoy when you see numbers on your device that you have never seen before that high. That will be what absolutely confirms to you that your device is correct, it is matching what they have there and their device at the clinic, and when you’re at home you don’t see those numbers.
And that means you don’t need pills.
My family got me a BP monitor with blue tooth capabilities - I was able to upload my average monthly results straight to my health care provider - meaning I didn’t have to make a trip over to the clinic (paid parking!).
Yesterday, I went to get an eye check up and the first thing they did was give me a BP test - I wasn’t expecting it - and my BP was 10 pts. higher than it is at home - but fortunately, still in the acceptable range.
I bought a brand called oxyline. Cost me $100. It has been tested and ranked at 99% accuracy 99% of the time. Comes with a lifetime guarantee. That’s good enough for me
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