A new drug called baxdrostat has stunned doctors by reversing a common cause of high blood pressure for years after patients stopped taking the medication. In a small study published in the New England Journal of Medicine, 14 patients with primary aldosteronism took daily pills for six to 12 months and then stopped. When doctors checked them up to two years later, their blood pressure remained lower. Prof Morris Brown, who led the study at Queen Mary University of London, noted that just under a quarter of the patients came off all treatment and had completely normal blood pressure. This potentially curative effect contrasts sharply with standard surgery, which removes the affected adrenal gland but does not always fully cure hypertension because other factors can contribute to the condition.
The Mechanism And Future Trials
Baxdrostat acts as an aldosterone synthase inhibitor, suppressing the hormone that signals kidneys to retain salt and raise blood pressure. Brown suspects the drug may cure the condition by causing a surge in reactive oxygen species that selectively destroy the cells overproducing the hormone. He stated, "Those oxygen radicals are killing the cells and they disappear," adding that this mechanism is testable and currently being investigated in the laboratory. The drug was approved in the US earlier this year for uncontrolled hypertension and is now being assessed by NICE, which could make it available through the NHS next year. However, Mason Freeman, a professor of medicine at Harvard University, cautioned that it is too early to say if some patients are truly cured. A larger trial is under way to determine if this persistent effect is common. If the approach proves effective, patients might avoid invasive diagnostic procedures and surgery entirely, dramatically changing how these conditions are managed.
