A New Drug for Hypertension After a Long Wait

The US Food and Drug Administration has approved Baxdrostat, the first oral aldosterone synthase inhibitor, for use in treating uncontrolled or resistant hypertension. The drug will be used in addition to existing antihypertensive treatments. Unlike classic mineralocorticoid receptor blockade, Baxdrostat works by directly suppressing aldosterone synthesis; this more selective mechanism aims to reduce side effects.

In patients whose blood pressure could not be controlled despite taking at least two antihypertensive drugs, adding baxdrostat produced a significant drop in systolic blood pressure. At 12 weeks of follow-up, systolic blood pressure fell by an average of 14.5 mmHg with the 1 mg dose and 15.7 mmHg with the 2 mg dose; in the placebo group, this drop was only 5.8 mmHg. In addition, systolic blood pressure was brought below 130 mmHg in about 40% of patients.

The most common side effect reported was hyperkalemia (high potassium). For this reason, monitoring serum potassium and sodium levels before and during treatment is recommended. Caution is needed regarding interactions with CYP3A inducers and drugs that raise potassium.

Conclusion: Baxdrostat will offer new hope for patients with uncontrolled HT

Source: Rudd, T. (2026, May 18). FDA greenlights novel hypertension pill for tough-to-treat patients. MedPage Today.