Efficacy and safety of baxdrostat in the management of uncontrolled hypertension: a systematic review and meta-analysis.
Hui Zhao, Tingli Xu, Yuan Liao et al.
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In 30 seconds
This systematic review and meta-analysis assessed baxdrostat versus placebo in randomized controlled trials involving patients with uncontrolled hypertension. Across five trials, baxdrostat was associated with reductions in seated systolic and diastolic blood pressure, ambulatory systolic pressure, and nocturnal systolic pressure, as well as a higher rate of blood pressure control. Each 1 mg increase in dose was associated with a 3.31 mm Hg reduction in seated systolic pressure. Hyperkalemia risk was elevated, underscoring a safety trade-off alongside the blood pressure benefit.
Key findings
- Seated systolic blood pressure was lower with baxdrostat than placebo (mean difference: -6.25 mm Hg; 95% CI, -8.75 to -3.74).
- Blood pressure control was more likely with baxdrostat (RR: 1.74; 95% CI, 1.23-2.46); only doses ≥2 mg improved control rate.
- Each 1 mg increase in baxdrostat dose was associated with a 3.31 mm Hg reduction in seated systolic blood pressure.
- Hyperkalemia risk was higher with baxdrostat (RR: 5.59; 95% CI, 3.47-9.02).
Why it matters
The findings suggest baxdrostat can lower blood pressure across several measurement settings in people with uncontrolled hypertension, with a dose-related effect. The increased hyperkalemia risk is clinically important when weighing potential benefit against harm. These pooled results help characterize both the blood pressure response and a key safety concern, but do not by themselves establish how the drug should be used in routine care.
What to keep in mind
The meta-analysis included five randomized trials; the abstract does not report follow-up duration or other details needed to assess longer-term efficacy and safety.