Baxdrostat significantly and substantially reduced systolic and diastolic blood pressure in patients with treatment-resistant hypertension, based on findings from the BrigHTN study presented Nov. 7 during AHA 2022 in Chicago and simultaneously published in the New England Journal of Medicine.

The multicenter trial randomly assigned 248 patients with treatment-resistant hypertension, blood pressure of 130/80 mm Hg or higher, and who were receiving stable doses of at least three antihypertensive agents, to either baxdrostat (0.5 mg, 1 mg, or 2 mg once daily) or placebo for 12 weeks. The primary endpoint was the change in systolic blood pressure from baseline to week 12 in each baxdrostat dosing group compared with the placebo group.

Results showed dose-dependent changes in systolic blood pressure of −20.3 mm Hg, −17.5 mm Hg, −12.1 mm Hg, and −9.4 mm Hg in the 2-mg, 1-mg, 0.5-mg and placebo groups, respectively. The greatest difference in the change in systolic blood pressure was observed between the 2-mg group and the placebo group was (−11.0 mm H). In presenting the findings, Mason W. Freeman, MD, also noted that baxdrostat reduced aldosterone levels and increased plasma renin activity without reducing cortisol, supporting its biological effect and selectivity. Additionally, baxdrostat was well tolerated and demonstrated a favorable safety profile with no deaths occurring during the trial and no serious adverse events attributed by the investigators.

Based on the results, Freeman said "baxdrostat has the potential to treat disorders associated with aldosterone excess, including hypertension and primary hyperaldosteronism."

Clinical Topics: Prevention, Hypertension

Keywords: AHA Annual Scientific Sessions, AHA22, Double-Blind Method, Treatment Outcome, Cytochrome P-450 CYP11B2, Antihypertensive Agents, Blood Pressure, Diabetes Mellitus, Hypertension, Potassium, Primary Prevention

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