AstraZeneca reports positive results from phase 3 blood pressure trial
AstraZeneca has announced positive results from its Bax24 trial of baxdrostat, an investigational treatment for hypertension, demonstrating clinically meaningful reductions in systolic blood pressure compared with placebo.
Results from the randomised, double-blind, placebo-controlled study were first presented during the Emerging Opportunities for Managing Cardiometabolic Syndrome late-breaking session at the American Heart Association (AHA) Scientific Sessions 2025.
The trial evaluated the efficacy and safety of 2 mg baxdrostat versus placebo in patients with treatment-resistant hypertension (rHTN). Baxdrostat is a first-in-class, highly selective small molecule that inhibits aldosterone synthase – an enzyme responsible for producing aldosterone, a hormone known to raise blood pressure and increase the risk of cardiovascular and renal complications. AstraZeneca acquired the candidate through its February 2023 acquisition of CinCor Pharma.
Baxdrostat met its primary endpoint, delivering clinically meaningful and sustained reductions in blood pressure throughout the 24-hour dosing interval, including during overnight and early morning periods, when cardiovascular risk is typically highest.
The study also achieved secondary endpoints, including reductions in ambulatory night-time average systolic blood pressure (SBP) and seated SBP. AstraZeneca noted that achieving consistent, round-the-clock blood pressure control represents an important clinical goal in patients with difficult-to-manage hypertension, as 24-hour SBP control is considered a stronger predictor of cardiovascular events than office-based measurements.
Sharon Barr, Executive Vice President, BioPharmaceuticals R&D, said: “The Bax24 data demonstrate the significant impact that baxdrostat’s long half-life and highly selective inhibition of aldosterone synthase can have in improving 24-hour and overnight blood pressure for patients with resistant hypertension. Patients with elevated night-time blood pressure are especially vulnerable to cardiovascular events, including heart attack and stroke. Together with the results from BaxHTN, these findings demonstrate the potential of baxdrostat to redefine what is possible for the millions of patients whose hypertension remains uncontrolled despite current therapies.”
In addition to its evaluation as a monotherapy for hypertension, baxdrostat is also being studied as a potential treatment for primary aldosteronism, and in combination with dapagliflozin for chronic kidney disease (CKD) and heart failure prevention in high-risk patients.
