New high blood pressure treatment works on resistant patients

New high blood pressure treatment works on resistant patients
©iStock/Deepak Sethi

A new drug has been shown to significantly reduce hypertension in patients who do not respond to existing high blood pressure treatment.

According to results from a phase II trial led by Queen Mary University of London, the drug Baxdrostat could be used to treat people with high blood pressure who have not responded well to previous treatment.

The study’s full findings have been published in the New England Journal of Medicine.

High blood pressure is a serious health issue in the UK

High blood pressure is a common cause of heart attacks, kidney failure and stroke. In most people, the cause of the condition is unknown, and they often need life-long high blood pressure treatment through drugs.

Roughly one-third of adults suffer from high blood pressure in the UK. In recent years, it has become evident that 5%-10% of people with high blood pressure also have a gene mutation in the adrenal glands, resulting in excessive amounts of aldosterone being produced. This affects an estimated 500,000 people in the UK.

This is the first time a new class of drugs to treat resistant hypertension has been developed and successfully tested. In the trial, 248 patients were given either a once-daily dose of Baxdrostat at varying amounts or a placebo. The researchers selected patients whose blood pressure had not been controlled despite taking three or more medicines for high blood pressure.

The Baxdrostat was taken in addition to the patient’s usual medicines. Doses ranged from 2mg to 1mg, to 0.5mg. At the end of the trial, the group that received the highest amount of Baxdrostat saw a 20-point fall in blood pressure. There was an 11-point difference between this group and the group that received the placebo. This level of difference is rarely seen in any single high blood pressure treatment.

Baxdrosta could become a common high-blood-pressure treatment

Baxdrostat prevents the body from making aldosterone, a hormone which regulates the amount of salt in the body. Baxdrostat also suppresses blood and urine levels of aldosterone. The researchers found that the drug can cause a marked fall in blood pressure in patients with hypertension resistant to typical drugs. The findings have suggested that this type of hypertension could be partly due to the excess production of aldosterone.

Drug developers have struggled to match Baxdrostat’s target enzyme, which makes aldosterone, with another enzyme that can make the essential steroid hormone, cortisol.

“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. But Baxdrostat could potentially offer hope to many people who do not respond to traditional hypertension treatment,” said Professor Morris Brown, co-senior author of the study and Professor of Endocrine Hypertension at Queen Mary University of London.

“The effectiveness of older drugs in individual patients can vary substantially, whereas a hallmark of this new class is that it can be predicted to work well in the patients whose aldosterone hormone has made them resistant to older treatments,” she added.

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