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

Preliminary research from the FigHTN Phase 2 clinical trial indicates that baxdrostat, a novel medication inhibiting aldosterone production, effectively lowers systolic blood pressure by approximately 5% when added to standard care in patients with chronic kidney disease and uncontrolled hypertension. The study, presented at the American Heart Association's Hypertension Scientific Sessions 2025 and simultaneously published in the Journal of the American Society of Nephrology, revealed that participants receiving baxdrostat experienced an average systolic blood pressure reduction of 8.1 mm Hg more than those on placebo after 26 weeks.

The research also demonstrated a 55% reduction in urine albumin levels among baxdrostat recipients compared to placebo, suggesting potential benefits in delaying kidney disease progression. Albuminuria, the presence of excess albumin in urine, serves as a critical marker for both kidney and cardiovascular risk. This reduction is comparable to effects seen with established kidney-protective medications, indicating baxdrostat's dual potential for blood pressure control and renal protection.

Chronic kidney disease and hypertension frequently coexist, creating a dangerous cycle where elevated blood pressure worsens kidney function, and declining kidney function further increases blood pressure. Aldosterone, a hormone produced by adrenal glands, plays a significant role in this relationship by promoting sodium retention, water retention, and blood vessel stiffening. Baxdrostat targets this pathway by inhibiting aldosterone production, offering a novel approach to breaking this cycle.

The study included 195 participants with an average age of 66 years, 32% of whom were women, 40% non-Hispanic white, and 80% had Type 2 diabetes. All participants had uncontrolled hypertension despite maximum tolerated doses of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, with average systolic blood pressure of 151 mm Hg at study initiation. Participants also had chronic kidney disease but were not in kidney failure, with average estimated glomerular filtration rate of 44 mL/min/1.73 and urine albumin-creatinine ratio of 714 mg/g.

Safety monitoring revealed that 41% of baxdrostat recipients experienced elevated potassium levels, a known side effect of medications affecting the renin-angiotensin-aldosterone system, compared to 5% in the placebo group. Most cases were mild to moderate. Serious adverse events occurred in 9% of baxdrostat recipients versus 3% in the placebo group, with no deaths or unanticipated adverse events reported during the trial.

These findings suggest baxdrostat could potentially improve long-term health outcomes, including reduced progression of kidney and cardiovascular conditions, while possibly decreasing the need for higher-cost care. The medication's dual benefits on blood pressure and kidney markers position it as a promising therapeutic option for a patient population historically underrepresented in clinical trials. Two large Phase 3 trials are currently underway to further evaluate baxdrostat's ability to delay kidney disease progression, building on these encouraging preliminary results.