A pill called baxdrostat reduced blood pressure in patients with treatment-resistant hypertension by an average of 20 mmHg systolic in a landmark Phase 3 clinical trial, researchers announced Monday at the American College of Cardiology annual conference in Chicago.
The trial enrolled 4,800 patients across 28 countries whose blood pressure remained above 140/90 mmHg despite taking at least three antihypertensive drugs. Participants receiving baxdrostat experienced reductions nearly double those seen in the placebo group, with 54 percent achieving guideline blood pressure targets compared to 22 percent of controls.
"These are the most compelling Phase 3 results I have seen in the resistant hypertension space in two decades of practice," said Dr. Elizabeth Nwachukwu, chief of hypertension at Johns Hopkins Medicine. "If the regulatory pathway is smooth, this could become a first-line option for the millions of patients for whom we have run out of tools."
Baxdrostat works by selectively inhibiting aldosterone synthase, an enzyme that drives aldosterone production. AstraZeneca said it would file for US FDA approval in Q3 2026 and expects European regulatory submissions to follow within six months.