A new pill considerably lowers dangerous blood pressure

It has been shown that a new powerful pill causes stubbornly high blood pressure that is resistant to standard treatments, according to the results of a historic global test.

The drug, the Baxdrostat, lowered the blood pressure by almost 10 mmHg on average – enough to reduce the risk of heart attack, stroke and kidney failure.

The revolutionary essay shows a new hope

Around the world, around 1.3 billion people live with high blood pressure (hypertension). In about half of these cases, the condition remains uncontrolled or does not meet standard treatments. This group faces a considerable risk of heart attack, stroke, kidney problems and early death. In the United Kingdom alone, around 14 million people are affected.

To meet this challenge, the researchers launched the Baxhtn international trial, produced by Professor Bryan Williams of the UCL Institute of Cardiovascular Science and sponsored by Astrazeneca. The study has tested a new oral medication, Baxdrostat, with nearly 800 patients participating in 214 medical centers worldwide.

The results of the study were shared on August 30 at the Congress of the European Cardiology Society (ESC) 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 a day in the form of a pill) experienced an average reduction in blood pressure from around 9 to 10 mmHg more than those which gave a placebo. This decrease is large enough to reduce cardiovascular risk significantly. About 40% of baxdrostat patients have reached healthy blood pressure levels, compared to less than 20% of those on site.

Professor Williams, principal researcher of the trial and principal presenter of the ESC, said: “The reduction of a reduction of almost 10 mmHg of systolic blood pressure with Baxdrostat in the BaxHTN Phase III trial is exciting, because this level of reduction is linked to a considerably lower risk of heart attack, stroke, heart failure and renal disease.”

How the pill works inside the body

The blood pressure is strongly influenced by a hormone called Aldosterone, which helps the kidneys to regulate salt and water balance.

Some people produce too much aldosterone, which means that the body maintains salt and water. This deregulation of aldosterone pushes blood pressure and makes control very difficult.

Tackling the deregulation of aldosterone has been a key effort to research for many decades, but it has so far been difficult to achieve.

Baxdrostat works by blocking the production of aldosterone, directly attacking this high blood pressure driver (hypertension).

An important step in the treatment

Professor Williams, president of medicine at UCL, said: “These results are an important advance in the treatment and in our understanding of the cause of blood pressure difficult to control.

“About half of the people treated for hypertension did not control it. However, this is a conservative estimate and that the number is probably higher, especially since the target blood pressure that we are trying to reach is now much lower than it was before.^[1]

“In patients with uncontrolled or resistant hypertension, the addition of Baxdrostat 1 mg or 2 mg once a day to background antihypertense therapy has led to clinically significant reductions in systolic blood pressure, which has persisted up to 32 weeks without imprecise safety results.

“This suggests that aldosterone plays an important role in the deposit of blood pressure difficult to control in millions of patients and offers hope for more effective treatment in the future.”

A global health challenge

Historically, Western high -income countries would have much higher levels of hypertension; However, largely due to the evolution of food regimes (adding less salt to food), the number of people living with the disease is now much higher in eastern and low -income countries. More than half of the affected people 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 worldwide-and up to 10 million people in the United Kingdom, in particular at the new target level for optimal blood pressure control.”

Notes

1. ESC 2024 hypertension guidelines recommended target blood pressure less than 130/80 mmHg. Before 2024, the lens was 140/90 mmHg.
2. UK’s blood pressure figures

Reference: “Baxdrostat efficiency and safety in uncontrolled and resistant hypertension” by John M. Flack, Michel Azizi, Jenifer M. Brown, Jamie P. Dwyer, Jakub Fronczek, Erika Sw Jones, Daniel S. Olsson, Shira Perl, Hirotaka Shibata, Ji-Guang Wang, Ulrica Witts and Bryan and Bryang Wang, Ulrica Wilderä, Janet Witts and Bryang Wang, Ulrica Wilderä, Williams, August 29, 2025, New England Journal of Medicine.
Two: 10.1056 / Nejmoa2507109

The study was supported by the NIHR biomedical research center at UCLH.

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