Now, there’s an experimental new drug that’s getting a lot of buzz because of how effective it is at controlling high blood pressure. It’s called baxdrostat, and the results of a recent phase 2 clinical trial found it was able to lower blood pressure by up to 20 points in patients who couldn’t control their high blood pressure with other drugs. The trial, published in JAMA and presented at the American Heart Association’s annual meeting, randomly assigned 248 patients with refractory high blood pressure to receive 0.5, 1 or 2 milligrams of baxdrostat once weekly or a placebo medicine . The researchers found that the drug was well tolerated by patients, and that those in the 2-milligram group saw their blood pressure drop by 20 points. (Worth noting: People in the placebo group also saw an 11-point drop, but the study’s researchers said that was likely because they were more diligent about taking their other medications during the study period.) Baxdrostat is not yet available to the masses – it must first go through phase 3 clinical trials and receive approval from the Food and Drug Administration. But it has already received a lot of attention based on its test results. But what is baxdrostat and who is it good for? Here’s what you need to know.
What is baxdrostat and how does it work?
Baxdrostat is an oral medicine that targets a hormone called aldosterone that regulates the amount of salt in your body. Baxdrostat blocks an enzyme your body needs to make aldosterone, explains study co-author Morris Brown, MD, professor of endocrine hypertension at Queen Mary University of London. “Aldosterone is a chemical in your body that will signal your kidneys to reabsorb water and sodium,” says Jamie Alan, Ph.D., associate professor of pharmacology and toxicology at Michigan State University. “When you retain more water, you increase your total blood volume, which increases blood pressure.” In the clinical trial, baxdrostat had no side effects different from placebo, with the exception of dizziness in some patients when their blood pressure dropped. Two patients also had an increase in their potassium levels, which can lead to heart rhythm problems, but were able to complete the study.
What is high blood pressure again?
Your blood pressure is a measure of how much blood is pushing against the walls of your arteries, which carry blood from your heart to other areas of your body, according to the Centers for Disease Control and Prevention (CDC). It’s normal for your blood pressure to rise and fall throughout the day, explains the CDC, but if it stays high for too long, it can damage your heart and cause health problems. High blood pressure, also known as hypertension, is blood pressure that is higher than normal. People are considered to have hypertension when they have a systolic blood pressure (the top number) higher than 130 mmHg or a diastolic blood pressure (the bottom number) higher than 80 mmHg, the CDC says. (Normal blood pressure is considered anything less than 120 mmHg / 80 mmHg.) High blood pressure doesn’t usually cause symptoms, according to the National Heart, Lung, and Blood Institute (NHLBI), but it can lead to serious health problems, such as aneurysm, stroke, heart attack, and heart failure.
What treatment options are currently available for high blood pressure?
There are a few different ways to manage high blood pressure, including lifestyle changes and taking certain medications, the NHLBI says. Lifestyle changes may include:
Eating heart-healthy foods like those in the DASH diet, along with a low-sodium diet. Avoiding or limiting alcohol. Regular physical activity. Trying to achieve and maintain a healthy weight. Avoiding smoking. Managing stress levels. Get enough sleep.
But for some people, lifestyle changes aren’t enough. There are many medicines that can help lower blood pressure, including:
Angiotensin-converting enzyme (ACE) inhibitors to prevent your blood vessels from narrowing too much. Angiotensin II receptor blockers (ARBs) to prevent narrowing of blood vessels. Calcium channel blockers to prevent calcium from entering the muscle cells of your heart and blood vessels. Diuretics such as thiazide to remove extra water and sodium from your body and reduce the amount of fluid in your blood. Beta blockers to help your heart beat more slowly and with less force.
But even these are not enough for some. In this case, they are diagnosed with what is known as resistant hypertension, which means they are taking three medications and still haven’t been able to significantly lower their blood pressure. “People who have resistant hypertension should be on three medications, including a diuretic, and that might do the trick,” says Dr. Brown. If this does not work, it is currently recommended that they try a drug called spironolactone, which, like baxdrostat, reduces the effect of aldosterone. “In some patients, that’s enough,” says Dr. Brown. “But the problem is that the dose can be limited by side effects.” (Common side effects of spironolactone include vomiting, diarrhea, increased hair growth, and fatigue, per Medline Plus.)
Why is a drug like baxdrostat needed?
Resistant hypertension is a problem, and it’s more common than many people realize, says Alan. “You might be surprised at the number of people who have treatment-resistant hypertension,” he says. “It turns out that the body is very good at compensating when you give it a drug that lowers blood pressure. It’s great to have another tool in the arsenal.”
Yu-Ming Ni, MD, a cardiologist at the MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, agrees, noting that he is “very excited” about the study’s results. “Patients with resistant hypertension have a really high risk of developing cardiovascular disease,” he says. “These patients really need much better treatments, and there are a lot of patients that we’re just struggling to help them get better.”
Thomas Boyden, MD, Corewell Health West medical director of preventive cardiology and cardiac rehabilitation, says the study results “were really very impressive” and “substantial when you look at other drugs.” He continues, “this offers many opportunities for patients,” provided future trials also have good results.
What’s next for baxdrostat?
It will be some time before baxdrostat is available to the masses. “A phase 2 study doesn’t always lead to success,” says Dr. Brown. However, he says, the researchers plan to do a phase 3 clinical trial early next year, which typically lasts 12 to 18 months. “Realistically, the earliest this drug could be licensed would be 2024,” says Dr. Brown. Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamor and more. He has a master’s degree from American University, lives by the beach and hopes to own a teacup pig and taco truck one day.
