New high blood pressure drug Baxdrostat shows promise in clinical trial

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Nearly half of American adults in the United States have high blood pressure, and only one in four of them have it under control. High blood pressure puts you at risk for serious complications like heart disease and stroke, making it a serious condition that is important to treat properly.

Now there’s an experimental new drug that’s making a lot of noise because of its effectiveness in controlling high blood pressure. It’s called baxdrostat, and results from a recent phase 2 clinical trial showed it was able to reduce blood pressure by up to 20 points in patients who have failed to control their hypertension with other drugs.

The lawsuit, which was published in JAMA and presented at the annual meeting of the American Heart Association, randomly assigned 248 patients with treatment-resistant high blood pressure to receive 0.5, 1, or 2 milligrams of baxdrostat once a week per day, or a placebo. The researchers found that the drug was well tolerated in patients, and people in the 2 milligram group saw their blood pressure drop by 20 points. (Note: People in the placebo group also saw an 11-point drop, but the researchers said in the study that this was likely because they were more diligent about taking their other medications during the dip). ‘study.)

Baxdrostat is not yet available to the general public – it must first go through phase 3 clinical trials and gain approval from the Food and Drug Administration. But it is already attracting a lot of attention based on the results of its trials.

But what is the baxdrostat and who is it used for? Here’s what you need to know.

What is baxdrostat and how does it work?

Baxdrostat is an oral medication that targets a hormone called aldosterone that regulates the amount of salt in your body. Baxdrostat blocks an enzyme your body needs to make aldosterone, says study co-author Morris Brown, MD, professor of endocrine hypertension at Queen Mary University of London.

“Aldosterone is a chemical in your body that will signal your kidney to reabsorb water and sodium,” says Jamie Alan, Ph.D., associate professor of pharmacology and toxicology at Michigan State University.. “When you retain more water, you increase your total blood volume, which increases blood pressure.”

In the clinical trial, baxdrostat had no different side effects than placebo, with the exception of dizziness in some patients when their blood pressure dropped. Two patients also had an increase in their potassium levels, which can lead to heart rhythm problems, but they were still able to complete the study.

What is high blood pressure again?

Your blood pressure is a measurement of blood pushing against the walls of your arteries, which carry blood from your heart to other areas of your body, according to the Centers for Disease Control and Prevention (CDC).

It’s normal for your blood pressure to rise and fall during the day, the CDC explains, but if it stays high for too long, it can damage your heart and cause health problems. High blood pressure, or hypertension, is higher than normal blood pressure. People are considered to have hypertension when they have systolic blood pressure (the top number) above 130 mmHg or diastolic blood pressure (the bottom number) above 80 mmHg, according to the CDC. (Normal blood pressure is considered to be below 120 mmHg / 80 mmHg.)

High blood pressure doesn’t usually cause symptoms, according to the National Heart, Lung, and Blood Institute (NHLBI), but it can lead to serious health problems, including aneurysm, stroke, heart attack, and heart failure. cardiac.

What treatment options are currently available for high blood pressure?

According to the NHLBI, there are several ways to manage high blood pressure, including lifestyle changes and taking certain medications.

Lifestyle changes may include:

  • Eat heart-healthy foods like those found on a DASH diet, as well as a low-sodium diet.
  • Avoid or limit alcohol.
  • Practice regular physical activity.
  • Try to achieve and maintain a healthy weight.
  • Avoid smoking.
  • Management of stress levels.
  • Get enough sleep.

But for some people, lifestyle changes aren’t enough. There are several medications that can help lower blood pressure, including:

  • Angiotensin converting enzyme (ACE) inhibitors to prevent your blood vessels from narrowing too much.
  • Angiotensin II receptor blockers (ARBs) to prevent blood vessels from narrowing.
  • Calcium channel blockers to prevent calcium from entering muscle cells in your heart and blood vessels.
  • Diuretics like thiazide to remove excess water and sodium from your body and reduce the amount of fluid in your blood.
  • Beta-blockers to help your heart beat slower and with less force.

But even these are not enough for some people. In this case, they are diagnosed with what is called resistant hypertension, which means they are on three medications and still have not been able to lower their blood pressure significantly. “People with resistant hypertension should take three medications, including a diuretic, and that may do the trick,” says Dr. Brown. If that doesn’t work, it’s currently recommended to try a drug called spironolactone which, like baxdrostat, decreases the impact of aldosterone. “In some patients, that’s enough,” says Dr. Brown. “But the problem is that the dosage can be limited by side effects.” (Common side effects of spironolactone include vomiting, diarrhea, increased hair growth and fatigue, according to Medline Plus.)

Why does a medicine look like need baxdrostat?

Resistant hypertension is a problem, and it’s more common than many people realize, says Alan. “You might be surprised how many people have treatment-resistant hypertension,” she says. “It turns out the body is really good at compensating when given a drug that lowers blood pressure. It’s great to have another tool in the arsenal.

Yu-Ming Ni, MD, a cardiologist at the MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, Calif., agrees, noting that he’s “very excited” about the study results. “Patients with resistant hypertension have a very high risk of developing cardiovascular disease,” he says. “These patients really need much better treatments, and there are a lot of patients that we just struggle to help them get better.”

Thomas Boyden, MD, Corewell Health West’s medical director for preventive cardiology and cardiac rehabilitation, says the study results “were really quite impressive” and “substantial when you look at other drugs.” He continues, “it offers a lot of opportunities for patients”, provided that future trials also have good results.

What happens next for the baxdrostat?

It will be some time before the baxdrostat is available to the masses. “A phase 2 study does not always lead to success,” says Dr. Brown. Still, he says, the researchers plan to do a Phase 3 clinical trial early next year, which typically takes 12 to 18 months. “In reality, the earliest this drug could get a license would be 2024,” says Dr. Brown.

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