New drug Baxdrostat may help fight high blood pressure

  • A new study highlights the effectiveness of a new drug against treatment-resistant high blood pressure.
  • Researchers have found that the new drug Baxdrostat has few side effects and is more effective than previous treatments.
  • Experts say the path of the new drug is cause for optimism.

In a new study published this week in The New England Journal of Medicineresearchers investigated whether a new drug could help people with high blood pressure.

In the phase II trial, the drug called baxdrostat reduced high blood pressure in patients whose condition was not resolved by other forms of treatment.

The drug is designed to block the production of aldosterone – a key hormonal contributor to hypertension – by blocking the enzyme that creates it.

The research was funded by CinCor Pharma which manufactures Baxdrostat.

Blood pressure is a measure of systolic and diastolic blood pressure.

The systolic measurement is the amount of pressure that blood exerts against the walls of the arteries when your heart beats.

Diastolic is the pressure exerted by blood on the walls of the arteries between each heartbeat.

Healthy blood pressure is defined as less than 120/80 or 120 mm Hg systolic/diastolic 80 mm Hg.

High blood pressure begins at or above 130 mm Hg systolic and above 80 mm Hg diastolic. High blood pressure can put you at many risks, including stroke, heart attack, or loss of vision,

The trial involved 248 patients who completed treatment. The process was placebo-controlled and had participants from multiple locations.

Study participants took the drug for 12 weeks and received 2 mg, 1 mg, 0.5 mg, or a placebo.

The researchers found that the effects were dose-dependent, meaning those who received a higher dose, on average, saw a greater drop in systolic blood pressure.

They found that the greatest drop in blood pressure was in people taking 2mg of the drug. They had a 20.3 mm Hg drop in their systolic blood pressure readings

This was compared with a 7.5 mm Hg, 12.1 mm Hg and 9.4 mm Hg drop in systolic blood pressure readings for the groups taking 1 mg, 0.5 mg of the drug and the placebo group respectively.

The study was stopped after 12 weeks because those supervising it found that it had reached the required level of effectiveness after 3 months.

Other findings include:

  • Only two patients saw adverse effects that the researchers linked to the drug. Both saw an increased level of potassium which did not return when treatment was stopped and restarted.
  • Baxdrostat, unlike other treatment options, did not increase cortisol levels. An increase in cortisol can have additional adverse effects and is linked to other reactions such as changes in inflammation levels

Experts who spoke to Healthline for this story are hopeful about the drug’s possible effects. The drug still has several rounds of additional testing before it can be considered for approval by the US Food and Drug Administration.

Patients with treatment-resistant hypertension, which the study found affects up to 12 million Americans, have often seen drugs like beta-blockers and diuretics fail to resolve their high blood pressure.

Experts say a major benefit of these results is that they allow for more selective treatment and don’t seem to cause as many side effects.

“From a clinical practice perspective, the challenge when you come to fourth- and fifth-line drug agents is: first, the value for money is often quite low; but second, you’re often dealing with drugs with quite a pronounced side effect profile,” Dr. Sameer Mehta, interventional cardiologist and president of Denver Heart, told Healthline.

He cites drugs like spironolactone and an older drug named clonidine as examples of long-standing drugs that can cause a wide range of side effects.

Mehta calls the level of blood pressure reduction in the study “dramatic” even as other treatments, such as the development of renal denervation in Europe, begin to be approved for study in the United States.

Dr. Aseem Desai, a cardiac electrophysiologist affiliated with Providence Mission Hospital, said the study is a good reminder that not all patients with hypertension will see results even if they follow their care plan.

“Often we attribute treatment-resistant hypertension to non-adherence, a patient not consistently taking prescribed medications, or not losing the target weight that we think will be helpful. to control their blood pressure, or that we didn’t get them to reduce sodium in their diet.And while this may be true, in many cases there is a small subset of patients who have genuinely treatment-resistant hypertension. They’re doing everything they can, and their numbers are still high,” Desai said.

He pointed to the study’s focus on the hormonal system, of which aldosterone is a part, as a key differentiator.

“The study underscores that what seems as small as a single hormone can have a profound effect on people with uncontrolled hypertension,” Desai added.

Dr. Camilo Ruiz, a caretaker and internist who now works primarily on sleep disorders, said issues with hypertension led him and his colleagues to look at other underlying issues that may be driving this resistance. .

“As an internist, I can start to wonder, ‘Well, does this patient have an underlying thyroid disorder? Does this patient have an underlying component of snoring and apnea? sleep? Does this patient have an underlying adrenal tumor that could be causing increased aldosterone hormone secretion? That’s how these patients present,” Ruiz said.

Of the three experts who spoke to Healthline, none shared deep concerns about the source of funding for this research. The main takeaway was that while it would be best to see independently funded research, the financial landscape of drug development in the United States simply makes it a very difficult goal to achieve.

“I think that’s the sad reality of healthcare today is that there are limited dollars,” Desai said.