New Medication Baxdrostat Shows Promise in Lowering Blood Pressure and Slowing Kidney Disease Progression
The novel medication baxdrostat demonstrated significant reductions in systolic blood pressure and urine albumin levels in patients with chronic kidney disease and uncontrolled hypertension, potentially offering new treatment options for this high-risk population.
Preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025 indicates that baxdrostat, a novel 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 levels by 55% compared to placebo.
Chronic kidney disease and high blood pressure are closely interconnected conditions that can lead to serious cardiovascular outcomes when poorly managed. Aldosterone, a hormone produced by the adrenal glands, plays a significant role in both conditions by promoting sodium retention, increasing water retention and blood pressure, and contributing to blood vessel stiffening and kidney scarring over time. The study, simultaneously published in the Journal of the American Society of Nephrology, involved 195 participants with an average age of 66 years, of whom 32% were women, 40% were non-Hispanic white, and 80% had Type 2 diabetes.
Participants had uncontrolled high blood pressure despite taking maximum tolerated doses of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, with average systolic blood pressure of 151 mm Hg at study initiation. All 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. After 26 weeks of treatment, those receiving baxdrostat experienced an average systolic blood pressure reduction of 8.1 mm Hg more than the placebo group.
The exploratory analysis revealed a 55% reduction in urine albumin levels among baxdrostat recipients compared to placebo, suggesting potential kidney-protective benefits comparable to medications known to delay kidney disease progression. High potassium levels occurred in 41% of baxdrostat recipients versus 5% in the placebo group, though most cases were mild to moderate. Serious adverse events were reported in 9% of baxdrostat recipients and 3% of placebo recipients, with no deaths or unanticipated adverse events during the trial.
These findings suggest baxdrostat may improve longer-term health outcomes and reduce the need for higher-cost care in this patient population. The medication's potential to delay kidney damage is now being tested in two large Phase 3 trials. Baxdrostat represents a new class of antihypertensive medications that inhibit aldosterone production and are being investigated for treating high blood pressure, chronic kidney disease, and heart failure. The medication is not yet approved by the U.S. Food and Drug Administration for any use.
The study was conducted at 71 sites across the United States and funded by AstraZeneca, the developer of baxdrostat. Research presented at American Heart Association scientific meetings is considered preliminary until published as a full manuscript in a peer-reviewed journal. Additional information about the American Heart Association's funding and policies is available at https://www.heart.org/en/about-us/statements-and-policies/financial-information.