Baxdrostat for uncontrolled and resistant hypertension: are we ready to change clinical practice?
Abstract
Resistant hypertension remains an important clinical challenge and is associated with a high risk of cardiovascular and kidney complications. Inappropriately elevated aldosterone production plays an essential role in its pathophysiology, prompting the development of selective aldosterone synthase inhibitors, such as baxdrostat. Recent clinical trials have demonstrated clinically meaningful reductions in office and ambulatory blood pressure with baxdrostat in patients with uncontrolled or resistant hypertension. However, uncertainties remain regarding long-term safety, the risk of electrolyte disturbances, its use in patients with advanced chronic kidney disease, direct comparisons with mineralocorticoid receptor antagonists, and its impact on cardiovascular and kidney outcomes. This article reviews the main clinical evidence on baxdrostat and discusses its potential role in the management of hypertension.
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BibTeX
@article{rodrigues2026baxdrostat,
title = {{Baxdrostat for uncontrolled and resistant hypertension: are we ready to change clinical practice?}},
author = {Cibele Isaac Saad Rodrigues and Ana Flávia Moura and Rodrigo Bezerra},
journal = {Brazilian Journal of Nephrology},
year = {2026},
month = nov,
doi = {10.1590/2175-8239-jbn-2026-0224en},
url = {https://doi.org/10.1590/2175-8239-jbn-2026-0224en},
note = {CC BY},
}
RIS
TY - JOUR
TI - Baxdrostat for uncontrolled and resistant hypertension: are we ready to change clinical practice?
AU - Cibele Isaac Saad Rodrigues
AU - Ana Flávia Moura
AU - Rodrigo Bezerra
PY - 2026
DA - 2026/11/03
JO - Brazilian Journal of Nephrology
DO - 10.1590/2175-8239-jbn-2026-0224en
UR - https://doi.org/10.1590/2175-8239-jbn-2026-0224en
AB - Resistant hypertension remains an important clinical challenge and is associated with a high risk of cardiovascular and kidney complications. Inappropriately elevated aldosterone production plays an essential role in its pathophysiology, prompting the development of selective aldosterone synthase inhibitors, such as baxdrostat. Recent clinical trials have demonstrated clinically meaningful reductions in office and ambulatory blood pressure with baxdrostat in patients with uncontrolled or resistant hypertension. However, uncertainties remain regarding long-term safety, the risk of electrolyte disturbances, its use in patients with advanced chronic kidney disease, direct comparisons with mineralocorticoid receptor antagonists, and its impact on cardiovascular and kidney outcomes. This article reviews the main clinical evidence on baxdrostat and discusses its potential role in the management of hypertension.
SN - 2175-8239
SN - 0101-2800
ER -