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Since these kidney-focused findings were reported in September 2025, additional baxdrostat data have added momentum to the drug’s development.
In the Phase 3 BaxHTN trial, published in the New England Journal of Medicine and presented at the European Society of Cardiology Congress 2025, baxdrostat significantly lowered seated systolic blood pressure in people with uncontrolled or resistant hypertension. AstraZeneca reported that the 2 mg dose lowered systolic blood pressure by 15.7 mm Hg from baseline, a 9.8 mm Hg placebo-adjusted reduction, after 12 weeks.
Later results from the Phase 3 Bax24 trial showed that baxdrostat lowered 24-hour ambulatory systolic blood pressure by 14.0 mm Hg compared with placebo in people with resistant hypertension. The study also found a 13.9 mm Hg placebo-adjusted reduction in nighttime systolic blood pressure. AstraZeneca said the results were being shared with regulatory authorities.
For chronic kidney disease specifically, baxdrostat is now being evaluated in combination with dapagliflozin in large Phase 3 studies. One trial is testing the combination in adults with chronic kidney disease and hypertension over a 24 month double blind period, while another renal outcomes study is assessing whether baxdrostat plus dapagliflozin can reduce the risk of major kidney and cardiovascular outcomes, including a sustained decline in eGFR, kidney failure, heart failure events, or cardiovascular death.
These later trials do not yet prove that baxdrostat prevents kidney failure. However, they show that researchers are now testing the bigger question raised by the Phase 2 results: whether lowering aldosterone can translate into long-term kidney and heart protection.
Study Details
The trial included 195 participants with an average age of 66 years. Among them, 32% were women, 40% were non-Hispanic white, and 80% had Type 2 diabetes. The study was conducted at 71 sites in the United States. Three participants were not randomized or included in the final analysis.
All participants had uncontrolled high blood pressure (systolic blood pressure of 140 mm Hg or higher, or 130 mm Hg or higher for people with Type 2 diabetes ) despite taking the maximum tolerated dose of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker among their medications. Their average systolic blood pressure was 151.2 mm Hg at the beginning of the trial.
Participants also had chronic kidney disease, but were not in kidney failure. Eligibility included an eGFR of 25 to 75 mL/min/1.73, with an average eGFR of 44 mL/min/1.73 at the start of the study, and a urine albumin-creatinine ratio of 100 mg/g or higher, with an average of 713.8 at the start of the study.
The 192 randomized participants were assigned to one of three groups: low-dose baxdrostat (0.5 mg/day, increasing to 1 mg/day after two weeks), high-dose baxdrostat (2 mg/day, increasing to 4 mg/day after two weeks), or placebo. After 26 weeks, researchers repeated blood pressure and kidney function testing. The primary analysis compared changes in systolic blood pressure across the three groups, and adverse events were tracked for each group.
