New Medication Baxdrostat Shows Promise in Lowering Blood Pressure and Kidney Disease Progression

Adding the novel medication baxdrostat to standard care may help manage high blood pressure and delay the progression of kidney disease in people with chronic kidney disease and uncontrolled high blood pressure, according to preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025. This study is simultaneously published today in the Journal of the American Society of Nephrology.

Chronic kidney disease and high blood pressure are closely linked and, when not managed appropriately, can lead to serious outcomes such as heart attack, stroke, heart failure and progression to kidney failure. Aldosterone, a hormone produced by the adrenal glands, can play a role in both high blood pressure and chronic kidney disease. Aldosterone causes sodium to be retained, which increases water retention and blood pressure. Over time, an excess of the hormone can lead to stiffening and thickening of blood vessels, which can contribute to heart damage and cause scarring in the kidneys, thereby playing a role in both high blood pressure and chronic kidney disease.

The study included 195 people with an average age of 66 years. Of the participants, 32% were women, 40% were non-Hispanic white and 80% had Type 2 diabetes. The study was conducted at 71 sites in the United States. All participants had uncontrolled high blood pressure despite taking the maximum tolerated dose of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker among their medications, with average systolic blood pressure of 151.2 mm Hg at the start of the study.

After 26 weeks, the average systolic blood pressure had fallen 8.1 mm Hg more in participants receiving either dose of baxdrostat than in those receiving the placebo, a reduction of about 5%. In an exploratory analysis, the researchers found the urine albumin level was 55% lower in those taking baxdrostat than in those taking a placebo, comparable to the reduction seen with medications that delay the progression of kidney disease.

High potassium levels in the blood, a known side effect of medications that block the renin-angiotensin-aldosterone system, occurred in 41% of participants on baxdrostat and 5% of those on placebo. Most cases were mild to moderate. There were no deaths or unanticipated adverse events during the trial, however, 9% of participants taking baxdrostat and 3% of those in the placebo group experienced a serious adverse event.

These findings suggest the potential for baxdrostat to improve longer-term health outcomes like kidney and cardiovascular conditions and reduce the need for higher-cost care for people with uncontrolled high blood pressure and chronic kidney disease. The reduction in urine albumin gives researchers hope that baxdrostat may also help delay kidney damage, with this potential now being tested in two large Phase 3 trials to determine if baxdrostat delays the progression of kidney disease.

Baxdrostat is in a class of medications that inhibit the production of aldosterone and are being tested for their ability to treat conditions such as high blood pressure, chronic kidney disease and heart failure. Baxdrostat is not approved for any use by the U.S. Food and Drug Administration. The study was funded by AstraZeneca, developer of baxdrostat.