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

Preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025 indicates that baxdrostat, a new medication targeting aldosterone production, may help manage uncontrolled high blood pressure and delay kidney disease progression in patients with chronic kidney disease. The FigHTN Phase 2 clinical trial results showed that adding baxdrostat to standard care reduced systolic blood pressure by approximately 5% and lowered urine albumin loss by 55% compared to placebo.

The study involved 195 participants with an average age of 66 years, all of whom had both chronic kidney disease and uncontrolled high blood pressure despite taking maximum tolerated doses of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. Participants had an average systolic blood pressure of 151 mm Hg and significant kidney disease markers at study initiation, with urine albumin levels averaging 714 mg/gm of creatinine and estimated glomerular filtration rate averaging 44 mL/min/1.73.

After 26 weeks of treatment, participants receiving either low-dose (0.5 mg-1 mg) or high-dose (2 mg-4 mg) baxdrostat experienced an average systolic blood pressure reduction of 8.1 mm Hg more than those receiving placebo. The medication's mechanism targets aldosterone, a hormone produced by adrenal glands that causes sodium retention, increased water retention, and elevated blood pressure. Over time, excess aldosterone can lead to blood vessel stiffening and kidney scarring.

The exploratory analysis revealed particularly promising results regarding kidney protection. Urine albumin levels, a key predictor of cardiovascular and kidney disease risk, were 55% lower in the baxdrostat group compared to placebo. This reduction is comparable to effects seen with medications known to delay kidney disease progression. Lead study author Jamie P. Dwyer, M.D., noted that these findings provide hope that baxdrostat may help delay kidney damage, with this potential now being tested in two large Phase 3 trials.

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

Jordana B. Cohen, M.D., M.S.C.E., immediate past chair of the American Heart Association's Hypertension and Kidney Cardiovascular Science Committee, emphasized the significance of including chronic kidney disease patients in this research, as this population has historically been excluded from many drug studies. The study was funded by AstraZeneca, developer of baxdrostat, and conducted at 71 sites across the United States. Additional information about the American Heart Association's research funding policies is available at https://www.heart.org/en/about-us/statements-and-policies/funding-sources.

It is important to note that these findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. The research abstract was presented at the American Heart Association's scientific meeting and simultaneously published in the Journal of the American Society of Nephrology. Baxdrostat is not currently approved for any use by the U.S. Food and Drug Administration.