New Pill Dramatically Lowers Dangerous High Blood Pressure

Scitech Daily ^ | September 03, 2025 | University College London

[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.

[omni-scientist]

That pretty much describes my experiences at the doctor's office. I wanted to know if my wrist BP monitor was accurately measuring both systolic & diastolic. On the first visit, the PA measured something like 175/90. Immediately after that my monitor read 176/89. So it was tracking pretty well.

That was after I handed her a spreadsheet printout for 30 days at home that showed twice a day I was averaging 122/78.

Knowing that, on a follow-up visit I was more relaxed and confident that I didn't have a problem. So my BP was lower then at 142/88, but still elevated.

White-coat syndrome is a real thing, but it is a misnomer. It is anxiety that is self-inflicted. I liken it to going into a final exam for which 50% of your grade is dependent on. In the doctor's office you know that there will be a "grade" that determines your doctors recommendation for a more aggressive drug treatment that you probably don't want or might not need.

[RideForever]

What if your ‘hypertension’ is actually caused by a protein spike causing inflammation from within blood vessels, and the swelling from within the vessels is causing the ‘high blood pressure’?

[Georgia Girl 2]

My best friend has a normal cholesterol reading of about 310. She has no blockage at all. It just runs high in the family.

[Owen]

Ya, it’s very common.

People wisely say I will do what the doc says to do.

Just make sure you show the doc home measurements. They all know about White Coat Hypertension. It is very common. The standard is you measure high in the office, but you say you just measured fine at home that morning. They will say do a 2 week log at home and send it in.

Don’t quibble over a few points here and there. If you are 170 at the office systolic and you EVER see 120s at home, well, then you don’t have hardening of the arteries, because they do not unharden just because you’re at home.

[Big Red Clay]

Bkmk

[Getready]

The drug inhibits the normal body synthesis of aldosterone. One of the effects of aldosterone is to increase sodium and water in blood leading to higher blood pressures.
There are three drugs already on the market for years ..but they inhibit the effect of aldosterone by blocking the aldosterone at the cellular site(receptor).
New drug decrease synthesis of aldosterone. Similar side effects but different chemicals. But both effect aldosterone activity.
.Recommend finding original study publication and reading it to get a better understanding of the relevance of the drug to modern antihypertensive regimens.
IMHO

[catnipman]

baxdrostat is still “investigational”, not having yet been approved by the FDA for human consumption, but if/when baxdrostat IS approved, it’ll cost only, say, $1,000/dose if it really is much more effective than existing medications ...

[daniel1212]

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).

Promising for some.

[metmom]

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.

Have you heard of Dr. Howard Schubiner?

Understanding Mind Body Syndrome.

https://unlearnyourpain.com/mind-body-syndrome/

He has posted a wealth of information on he web, and offers much of it for free, and does not sell supplements or *cures*.

Interesting stuff though and much of it makes a lot of sense.

The first thing for ANYONE to do though, is rule out ANY possibility that there is a true physical cause, like heart attack, stroke, cancer, etc. One CANNOT assume that their symptoms are brain conditioned to begin with.

But if no physical cause can be found for the problem, then it's time to consider this option as it is becoming more evident that the brain is far more powerful and exerts much greater influence on the body than was previously thought.

We are not just a collection of parts or systems that operate independently.

[algore]

Doctors love to put you on any kind of recurring medicines cause that causes them to have a recurring revenue stream.

[SuperLuminal]

Dang!
For the past 15 years, my blood pressure (measured & charted at least 4 days a week at cardiologist’s request) has been between 129 and 139... My wife’s BP ranges from 105-118...

We are both on Metoprolol: Wife=25mg... Me=50mg...

When my wife and I go to his office, we both always measure BP in the 145-155 range... Even our BP machines, which we take with us to verify the home-charted readings, agree with those high office readings...

[LadyDoc]

Most bp meds lower bp by 10mm

And spironolactone is an aldosterone blocker.