SynthesisCardiovascular drugs and therapy2026
Baxdrostat in Resistant and Uncontrolled Hypertension: A Systematic Review and Meta-Analysis.
Synthesis in Cardiovascular drugs and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
backgroundAldosterone dysregulation is becoming more widely acknowledged as a key factor in resistant hypertension. Baxdrostat, a highly selective aldosterone synthase inhibitor that shows a 100:1 preference for CYP11B2 over CYP11B1, has been tested in various randomized controlled trials involving different hypertensive groups. We carried out a systematic review and meta-analysis to assess the efficacy and safety of baxdrostat for treating resistant hypertension.
methodsWe included randomized, double-blind, placebo-controlled trials of baxdrostat in adults with hypertension from inception through March 2026. The primary outcome was the placebo-corrected change in seated systolic blood pressure (SBP). Secondary outcomes included the change in diastolic blood pressure (DBP), the proportion of patients achieving seated SBP < 130 mmHg, and the incidence of hyperkalemia and other adverse events.
resultsFive trials (N = 1,730) were included: BrigHTN, HALO, BaxHTN, FigHTN, and Bax24. Baxdrostat significantly reduced seated SBP vs. placebo (MD -6.90 mmHg; 95% CI, -10.25 to -3.55; P < 0.0001), with high heterogeneity (I
conclusionsBaxdrostat produces statistically significant reductions in systolic blood pressure among various hypertensive populations, increasing the likelihood of achieving blood pressure targets (SBP < 130 mmHg), although the magnitude of this effect varied substantially across trials (I² = 89%). Hyperkalemia was the principal safety concern but was not associated with serious clinical sequelae in the included trials. These findings support further investigation of aldosterone synthase inhibition as a therapeutic strategy for resistant and uncontrolled hypertension, with definitive clinical positioning awaiting results from ongoing cardiovascular and renal outcomes trials.
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