Queen Mary University of London: baxdrostat for six months lowered blood pressure in fourteen patients

In early November 2026, a team from Queen Mary University of London published results in the New England Journal of Medicine, reported by science-et-vie.com. Fourteen patients with hypertension completed the full protocol with baxdrostat, given for six to twelve months, in eight centres in the United States science-et-vie.comscience-et-vie.comscience-et-vie.comOpen source ↗. Doctors reviewed them repeatedly, up to two years after the last tablet.

Aldosterone and primary hyperaldosteronism

Current drugs control blood pressure without acting on its cause, and patients take them for life. The target here is aldosterone, a hormone made by the adrenal glands that retains salt and water. Produced in excess, it raises blood pressure, a condition called primary hyperaldosteronism. It would explain 5 to 10 % of hypertension cases but is rarely looked for in consultations. Many patients also have low potassium, which tires muscles and causes cramps.

The idea comes from a 2005 experiment in mice. Deleting the gene for aldosterone synthase made the hormone-producing cells disappear, and none grew back.

What the follow-up showed

The main marker of aldosterone excess remained 99 % lower than before treatment. Blood pressure fell by 25 millimetres of mercury on average science-et-vie.comscience-et-vie.comscience-et-vie.comOpen source ↗. Earlier trials of this family of molecules lasted six to twelve weeks and measured blood pressure only during treatment, never after it.

Several patients saw their hypertension disappear completely, while others improved only partly. The potassium deficiency was corrected, and several patients stopped all tablets. None needed surgery, whereas removal of an adrenal gland is currently the only curative option for these patients.

The authors note limits. The group was too small to draw conclusions, there was no control group, and the pragmatic design limits the weight of the figures. Nothing proves that the aldosterone-producing cells actually disappeared, and Morris Brown, who led the work, is cautious on this point.

A larger trial, ELIXIR, is to enrol about thirty patients, who will receive baxdrostat for twenty-four weeks. Molecular imaging of the adrenal glands will track the activity of aldosterone-producing cells before and after the course science-et-vie.comscience-et-vie.comscience-et-vie.comOpen source ↗.