A More-Effective Aldosterone Synthase Inhibitor for Resistant Hypertension?

Aldosterone synthase is the enzyme that controls synthesis of aldosterone, excess of which is known to cause hypertension, particularly resistant hypertension. To assess the efficacy and safety of baxdrostat, a non–FDA-approved selective inhibitor of aldosterone synthase, investigators performed a manufacturer-funded, multicenter, phase 2 trial (NCT04519658).

The study included 275 patients with resistant hypertension (blood pressure ≥130/80 mm Hg despite treatment with at least 3 antihypertensive medications, including a diuretic) who were randomized to receive baxdrostat (0.5 mg, 1 mg, or 2 mg) or placebo once daily for 12 weeks. Baxdrostat significantly reduced blood pressure in a dose-dependent manner, with placebo-corrected systolic blo…