 "New drug offers hope for Indians with drug-resistant hypertension")
Baxdrostat, a new blood pressure pill, may “immensely reduce” cardiovascular risk among patients who have uncontrolled hypertension despite taking multiple medications, according to experts.
Results from a trial conducted by University College London showed that Baxdrostat, which is developed by British-Swedish pharmaceutical and biotechnology company AstraZeneca, reduced systolic blood pressure by an additional 9-10 mmHg compared to a placebo, with four in ten patients reaching normal levels. The drug has been presented at international cardiology forums and is expected to be launched in India soon.
In India, where hypertension affects nearly a third of adults and resistant hypertension is rising due to obesity, diabetes and sedentary lifestyle, the findings are significant. Uncontrolled blood pressure is a leading cause for heart attacks, strokes, kidney disease and heart failure.
“An extra 10 mmHg drop in blood pressure can immensely reduce cardiovascular risk. By directly inhibiting surplus aldosterone, one of the root causes of resistant hypertension, Baxdrostat represents a key step forward,” said Nimit C Shah, consultant interventional cardiologist at Saifee Hospital in Mumbai.
Experts said that Baxdrostat could help Indian patients whose resistant hypertension is often driven by undiagnosed aldosterone excess, a condition for which routine testing is limited due to costs.
“This drug is definitely a big step forward,” said Pravin Kahale, consultant, cardiology, Kokilaben Dhirubhai Ambani Hospital in Mumbai. “I don’t remember in the last 20 years any new medication in hypertension that could be called a real game changer.”
The drug could also help delay kidney failure and the need for dialysis in diabetic patients with uncontrolled blood pressure, said Kahale.
Dhiman Kahali, a cardiologist at B M Birla Heart Hospital in Kolkata, said Baxdrostat is similar to spironolactone but offers comparable efficacy with fewer hormonal side effects.
Spironolactone is effective but causes significant endocrine side effects (such as gynecomastia, loss of libido, and menstrual issues), according to Kahali. Baxdrostat, while working through a slightly different mechanism, shows similar efficacy in lowering blood pressure without the hormonal side effects. However, like other drugs in this class, it can raise potassium levels.
Kahali noted that there are several drugs in India to treat resistant hypertension, so Baxdrostat is “not a complete breakthrough, but rather an important alternative with fewer side effects”.
Kahale explained that unlike spironolactone, a fourth-line drug to treat resistant hypertension, Baxdrostat works upstream by blocking aldosterone production itself, potentially offering stronger efficacy with fewer hormonal side effects.