A new daily pill called baxdrostat lowers high blood pressure for up to two years after patients stop taking the medication, according to a study published in the New England Journal of Medicine.
More than a billion people globally live with hypertension, including over 12 million in the UK. For 5 to 10 percent of these patients, small benign tumors or nodules on the adrenal glands cause an overproduction of the hormone aldosterone, which signals kidneys to retain salt and raise blood pressure. Standard treatment involves surgically removing the affected gland, though surgery does not always cure the condition entirely.
Baxdrostat functions as an aldosterone synthase inhibitor designed to suppress the hormone that raises blood pressure. The drug received approval in the US earlier this year for patients with hypertension uncontrolled by existing medications, and the National Institute for Health and Care Excellence is assessing it for potential NHS availability next year.
A small study examined 14 patients whose hypertension improved during a three-month trial of the drug. These participants continued taking the daily pills for six to 12 months before stopping completely. Follow-up checks up to two years later revealed that their blood pressure remained lower.
Just under a quarter of the patients came off all treatment and had completely normal blood pressure,
said Prof Morris Brown, a hypertension specialist at Queen Mary University of London who led the study.
Researchers are working to determine if the drug provides a permanent fix for the condition. Mason Freeman, a professor of medicine at Harvard University who participated in the research, noted that determining whether patients are truly cured requires larger trials.
If this effect is common and very persistent then the approach to diagnosing and treating these patients is likely to dramatically change,
Freeman said. He added that patients could potentially avoid invasive diagnostic procedures and surgery if initial treatment with the inhibitor proves effective.
Brown suspects the medication destroys the specific cells overproducing aldosterone. He pointed to a 20 years old mouse experiment where deleting the gene responsible for aldosterone production caused the hormone-producing cells to die off. He believes baxdrostat triggers a similar reaction by generating a surge of reactive oxygen species that selectively eliminate those cells.
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