A new daily pill has shown continuous, round-the-clock control of high blood pressure in people whose condition is difficult to manage, according to a global study led by Professor Bryan Williams, UCL Institute of Cardiovascular Science and supported by the BRC.
The findings build on an earlier international trial, called BaxHTN, also led by Professor Williams and published in the New England Journal of Medicine earlier this year. This landmark trial showed that the drug baxdrostat substantially lowers blood pressure in people who do not respond to existing blood pressure medications. Baxdrostat works by reducing levels of aldosterone, a hormone that can drive high blood pressure in some individuals.
In the new study, Bax24, researchers found that the drug’s effect was sustained over 24 hours - including at night and early morning, when the risk of heart attack and stroke is highest.
The study, sponsored by AstraZeneca, involved 218 participants across 79 sites worldwide whose blood pressure remained high despite taking at least three other medications. Participants received either baxdrostat or a placebo once a day, alongside their usual therapy, for 12 weeks. Blood pressure was monitored using a wearable 24-hour device, which provides a more accurate picture of blood pressure control than single clinic readings and better predicts risk of heart attack and stroke.
Results, presented at the American Heart Association Scientific Sessions conference in New Orleans, showed a substantial and consistent reduction in blood pressure - an effect that current treatments rarely achieve. Results awaiting peer review.
Professor Williams said: “For millions of people, high blood pressure is difficult to control, even with multiple medications. Persistent high blood pressure massively increases the risk of heart disease, stroke, and kidney disease. The Bax24 trial results are quite remarkable both in terms of the magnitude of blood pressure reduction and the fact that it was sustained across the entire 24 hour period.”
Both the BaxHTN and Bax24 trials were supported by the NIHR UCLH Biomedical Research Centre and baxdrostat is licenced by AstraZeneca.
