A novel medication has astonished medical professionals by successfully reversing a frequent underlying cause of high blood pressure for years after patients stopped taking the medication, offering potential relief to millions.
Patients who took the daily pills of a medication known as baxdrostat experienced improvements in their blood pressure during a treatment period lasting six to 12 months, and surprisingly, these positive effects persisted for up to two years afterward. Some patients were no longer on any hypertension drugs and were potentially cured of the condition.
Hypertension affects upwards of a billion individuals across the globe, a figure that includes more than 12 million people in the UK. Benign growths or tiny nodules on the adrenal glands prompt them to excessively secrete an aldosterone hormone in 5 to 10% of cases. The excess hormone raises blood pressure by signalling the kidneys to retain salt.
The standard treatment for primary aldosteronism is to surgically remove the affected adrenal gland, though other factors can contribute to patient hypertension, meaning surgery is not always a complete cure. Baxdrostat is known as an aldosterone synthase inhibitor (ASI) which suppresses the blood pressure-raising hormone.
Earlier in the year, US regulators cleared the medication for use among individuals whose hypertension remains unmanaged by traditional therapies. The National Institute for Health and Care Excellence (Nice) is currently evaluating the treatment, a process that could potentially introduce the medication to the NHS by next year.
Observations from a compact clinical investigation revealed the potential curative capabilities of baxdrostat after tracking 14 participants who experienced significant blood pressure reductions over a three-month evaluation period. They continued taking the daily pills for six to 12 months and then stopped, and when doctors checked the patients up to two years later, their blood pressure was still lower, according to details published in the New England Journal of Medicine.
“It’s very exciting to see,” said Prof Morris Brown, a hypertension specialist at Queen Mary University of London, who led the study. “Just under a quarter of the patients came off all treatment and had completely normal blood pressure.”
Brown suspected the drug may cure primary aldosteronism because of an experiment in mice 20 years ago. Previous research involving the deletion of the specific gene required for aldosterone production resulted in the disappearance of the cells responsible for generating the hormone, leading him to hypothesize that baxdrostat operates through a comparable mechanism.
When the drug suppresses aldosterone it causes a surge in highly active molecules called reactive oxygen species, which may selectively destroy the cells that overproduce the hormone. “Those oxygen radicals are killing the cells and they disappear,” Brown said. “That’s what I think the mechanism is and it’s testable, it’s something we’re doing now in the laboratory.”
Harvard University professor of medicine Mason Freeman, who participated in the research, noted that determining whether any participants achieved a full recovery remains premature, prompting a larger-scale investigation to gain clarity. he said.
