New drug could be cure for common cause of high blood pressure

A groundbreaking drug called baxdrostat has shown the potential to cure a common cause of high blood pressure, known as primary aldosteronism, for years after patients stop taking it. Baxdrostat, an aldosterone synthase inhibitor (ASI), curbs the hormone that triggers hypertension by signaling the kidneys to retain salt. The drug, approved for use in the US, is now being studied by the National Institute for Health and Care Excellence (Nice) for possible NHS availability.

In a trial involving 14 patients, blood pressure improved during a three-month course of baxdrostat. Strikingly, the benefits persisted up to two years after patients discontinued the medication, with some no longer needing any hypertension drugs. Prof Morris Brown, a hypertension specialist at Queen Mary University of London, expressed excitement over the findings, stating that a quarter of patients were able to come off all treatment and achieve normal blood pressure.

The drug's potential curative effect emerged from a small study, where patients experienced significant improvements in hypertension during a three-month trial. They continued the daily pills for six to 12 months and then stopped, only to have their blood pressure remain lower up to two years later. Brown suspects that baxdrostat's mechanism of action may cause a surge in reactive oxygen species, which selectively destroy cells that overproduce the hormone, leading to their disappearance.

Should the findings hold true in larger trials, primary aldosteronism treatment could change dramatically. Patients could potentially be treated with an ASI in the initial stages of suspicion, avoiding invasive diagnostic procedures and surgery. The drug's effectiveness in curing the condition could benefit over a billion people worldwide, including more than 12 million in the UK who suffer from high blood pressure.