Decreasing the Effects of Aldosterone in Resistant Hypertension — A Success Story

This editorial discusses the challenges of treating resistant hypertension, a condition affecting 20% of hypertensive patients, characterized by uncontrolled blood pressure despite multiple medications. The article highlights the role of excessive aldosterone secretion in salt retention and evaluates treatment options, including mineralocorticoid receptor antagonists like spironolactone and the novel selective aldosterone synthase inhibitor baxdrostat. A phase 2 trial demonstrated baxdrostat's efficacy in reducing systolic blood pressure by up to 11.0 mmHg without affecting cortisol levels, though it posed a risk of hyperkalemia. The editorial underscores the need for further trials to compare baxdrostat with existing therapies and to assess long-term safety. The findings suggest promising avenues for managing resistant hypertension and primary aldosteronism.

This editorial discusses the challenges of treating resistant hypertension, a condition affecting 20% of hypertensive patients, characterized by uncontrolled blood pressure despite multiple medications. The article highlights the role of excessive aldosterone secretion in salt retention and evaluates treatment options, including mineralocorticoid receptor antagonists like spironolactone and the novel selective aldosterone synthase inhibitor baxdrostat. A phase 2 trial demonstrated baxdrostat's efficacy in reducing systolic blood pressure by up to 11.0 mmHg without affecting cortisol levels, though it posed a risk of hyperkalemia. The editorial underscores the need for further trials to compare baxdrostat with existing therapies and to assess long-term safety. The findings suggest promising avenues for managing resistant hypertension and primary aldosteronism.