CAMBRIDGE, U.K., Oct. 8, 2025 — Hypertension affects over a billion adults globally and is a leading contributor to heart attacks, strokes, and kidney disease. Among these patients, a subset experiences resistant hypertension, where blood pressure remains high despite multiple medications. This group is particularly vulnerable to cardiovascular complications and often has limited treatment options.

AstraZeneca’s Bax24 Phase III trial provides a potential turning point. The investigational drug Baxdrostat targets aldosterone synthase, an enzyme that drives the production of aldosterone, a hormone that influences sodium and water balance in the body. Overproduction of aldosterone can worsen blood pressure control, and by inhibiting this enzyme, Baxdrostat helps restore balance and improve cardiovascular outcomes.

How Does Baxdrostat Deliver Results

The Bax24 trial was a global, randomized, placebo-controlled study designed to test Baxdrostat in patients already taking multiple antihypertensive medications. The primary endpoint was the change in 24-hour average systolic blood pressure, a measure that captures fluctuations throughout the day and night.

Patients taking Baxdrostat experienced a statistically significant and clinically meaningful reduction in systolic blood pressure compared to those on placebo. Importantly, this effect was sustained during early morning hours, when the risk of heart attacks and strokes is highest. Continuous blood pressure control like this is crucial for reducing long-term cardiovascular risks.

What This Means for Patients

Resistant hypertension has long been a challenge for both patients and physicians. Baxdrostat’s results suggest it could become an important addition to treatment options for those who have struggled to control their blood pressure with existing therapies.

Safety and Tolerability: The trial showed that Baxdrostat was generally well tolerated. The incidence of adverse events was similar to the placebo group, and no new safety concerns were identified. This suggests it could be safely added to current antihypertensive regimens without introducing unexpected risks.

Potential Clinical Impact: Beyond lowering blood pressure, Baxdrostat addresses a fundamental biological mechanism behind resistant hypertension. By targeting aldosterone production, it may improve outcomes for patients who have had limited success with conventional therapies. This mechanism opens the door for more stable blood pressure control and potentially fewer cardiovascular events over time.

Why This Breakthrough Matters

Resistant hypertension has remained one of the most difficult conditions to treat in cardiovascular medicine. Many patients continue to face high risks despite multiple medications. Baxdrostat represents a shift toward precision-targeted therapies that address the underlying causes of the condition rather than simply managing symptoms.

The drug’s sustained 24-hour effect, targeted mechanism, and favorable safety profile make it a compelling option for both clinicians and patients. This development could also encourage further research into aldosterone-focused therapies and help improve treatment outcomes for patients with resistant hypertension.

 

Inputs from Diana Chou

Editing by David Ryder