Description

Resistant hypertension remains one of the most stubborn challenges in cardiovascular medicine.

The Bax24 phase 3 trial, published in The Lancet (2026), evaluated baxdrostat, a selective aldosterone synthase inhibitor, in patients already receiving multiple antihypertensive agents.

Key findings:

• −16.6 mmHg reduction in 24-hour ambulatory SBP

• −14.0 mmHg placebo-corrected difference (p<0.0001)

• 71% achieved BP control (<130 mmHg) vs 17% placebo

• Acceptable safety profile, with hyperkalemia in 3%

These data highlight the growing importance of aldosterone dysregulation in resistant hypertension and suggest that targeted aldosterone synthase inhibition may represent a new therapeutic frontier.

Reference: Azizi M et al. Effect of Baxdrostat on Ambulatory Blood Pressure in Resistant Hypertension (Bax24). Lancet 2026.