New Drug Lowers Treatment-Resistant High Blood Pressure and May Slow Kidney Disease
A new drug has shown unprecedented promise in lowering blood pressure and preventing the progression of kidney disease for people with hard-to-treat hypertension. The medication, baxdrostat, reduces the levels of a hormone that drives high blood pressure and could transform hypertension care.
In a stage 2 clinical trial with nearly 200 people, baxdrostat significantly lowered blood pressure. An exploratory analysis of kidney function revealed that baxdrostat also reduced the level of a marker for kidney disease to less than half of that of people provided with standard care.
A one-two punch to kidney disease and hypertension
Hypertension is the biggest risk factor for chronic kidney disease (CKD), a serious condition that is currently irreversible except in early stages. The progression of CKD can be measured by the level of a protein called albumin in the urine: the higher the level of albumin, the worse kidney function is. The research team, led by Jamie Dwyer, MD, professor of nephrology and hypertension and assistant vice president for clinical research at 麻豆学生精品版, primarily investigated baxdrostat鈥檚 effects on blood pressure. However, they checked kidney function as well in an exploratory analysis.
Preliminary results show that after half a year of treatment, people who received baxdrostat had less than half the levels of urine albumin as their peers undergoing standard treatment, suggesting that their kidneys were markedly healthier. Phase III clinical trials are underway to further test baxdrostat鈥檚 impact on kidney function.
The study also showed that the drug lowers blood pressure by, on average, 8.1 mm Hg more than standard-of-care treatment. Another clinical trial involving almost 800 patients, on which Dwyer was a global steering committee member, showed . Baxdrostat is already being widely hailed as a 鈥済ame changer鈥 for its effects on hypertension.
A new kind of hypertension drug
Baxdrostat works by a different mechanism than existing blood pressure medications, which could explain why it works in cases where other medications have failed to sufficiently lower blood pressure.
Up to 25% of people with treatment-resistant hypertension鈥攄efined as blood pressure that stays too high even while a patient is treated with at least three blood pressure medications鈥攈ave higher-than-normal levels of a hormone called aldosterone. High levels of aldosterone can raise blood pressure by increasing the level of salt in the blood and can also make chronic kidney disease worse by contributing to kidney inflammation and scarring.
Medications that target the receptor for aldosterone are often used as a therapy for treatment-resistant hypertension. But baxdrostat goes to the source by reducing aldosterone production itself.
By lowering levels of aldosterone, baxdrostat not only reduces blood pressure but could aid kidney health, transforming treatment for the one in seven U.S. adults who live with kidney disease.
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This work was supported by AstraZeneca.