Baxdrostat Trials Cut Blood Pressure
Just under a quarter of patients in a small study dropped all hypertension medications after taking a daily pill called baxdrostat, published in the New England Journal of Medicine.
More than a billion people globally live with high blood pressure. That total includes over 12 million individuals in the UK.
Tumours Trigger Excess Aldosterone
Primary aldosteronism causes 5% to 10% of hypertension cases. Small benign tumours or nodules on the adrenal glands force them to overproduce the hormone aldosterone, which signals kidneys to retain salt.
Surgery removes the affected gland to fix the imbalance, but other factors often contribute to high blood pressure. That means operations do not always cure the condition completely.
Drug Suppresses Hormone Production
Baxdrostat works as an aldosterone synthase inhibitor to suppress the hormone that raises blood pressure. The drug received US approval earlier this year for patients who do not respond to existing medications.
The National Institute for Health and Care Excellence is assessing the treatment. The evaluation could make the drug available through the NHS next year.
Patients Maintain Lower Blood Pressure Levels
The trial tracked 14 patients whose hypertension improved during a three-month course of the pills. They continued taking the daily medication for six to 12 months before stopping entirely.
Doctors checked the participants up to two years later and found their blood pressure remained lower. “Just under a quarter of the patients came off all treatment and had completely normal blood pressure,” said Prof Morris Brown, who led the study at Queen Mary University of London.
The 14 patients experienced an average fall of 25 millimetres of mercury in their systolic blood pressure during the trial.
Researchers Investigate Cellular Destruction
Scientists suspect the medication triggers a surge in reactive oxygen species when suppressing aldosterone. These highly active molecules may selectively destroy the cells that overproduce the hormone.
“Those oxygen radicals are killing the cells and they disappear,” Brown said. He noted that a 20-year-old experiment in mice showed deleting the gene needed for aldosterone led to the loss of hormone-producing cells.
Harvard University professor of medicine Mason Freeman, who took part in the work, said a larger trial is underway. “If this effect is common and very persistent then the approach to diagnosing and treating these patients is likely to dramatically change,” he said.
Frequently Asked Questions About Baxdrostat
When could baxdrostat become available on the NHS?
The National Institute for Health and Care Excellence is assessing the medication to decide if the NHS will offer it next year.
How many patients stopped taking hypertension treatments?
Just under a quarter of the participants in the study stopped all treatments and maintained completely normal blood pressure.
What causes primary aldosteronism?
Small benign tumours or nodules on the adrenal glands cause the glands to overproduce aldosterone, which raises blood pressure.
How long did patients maintain lower blood pressure after stopping the pills?
Follow-up checks showed patients maintained lower blood pressure levels for up to two years after stopping the medication.
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