BrigHTN: Baxdrostat for Resistant Hypertension

Dr. Tashko serves as a blood pressure specialist in Rockville, Montgomery County, Maryland. With extensive expertise in cardiovascular health, Dr. Tashko plays a pivotal role in diagnosing and managing blood pressure issues for patients in the area. Through comprehensive evaluations, he accurately assesses patients' blood pressure levels and identifies potential risk factors. Utilizing his deep understanding of medical conditions and their impacts, Dr. Tashko develops personalized treatment plans that may include lifestyle adjustments, medications, and regular monitoring. Patients under Dr. Tashko's care benefit not only from his medical proficiency but also from his compassionate approach. He takes the time to educate his patients about the importance of blood pressure management and empowers them to take an active role in their health journey. Dr. Tashko's dedication extends beyond the clinic, as he stays current with the latest advancements in blood pressure research and treatment modalities. This commitment ensures that his patients receive the most up-to-date and effective care available. In Rockville, Montgomery County, Dr. Tashko is highly regarded not only for his medical acumen but also for his commitment to improving the cardiovascular well-being of his patients. His contributions to the field of blood pressure management make him an invaluable asset to the community. Whether it's preventing hypertension or helping those with existing conditions, Dr. Tashko's expertise positively impacts the lives of many in the region.

November 2022 NEJM

Aldosterone physiology.

Aldosterone, a hormone crucial for blood pressure regulation, plays a significant role in promoting salt and water retention by the kidneys. Excessive levels of aldosterone can lead to hypertension. The enzyme responsible for the synthesis of aldosterone is aldosterone synthase (AS), which bears a striking 93% similarity to cortisol synthase (CS, CYP11B1), an enzyme vital for maintaining human physiology and vitality.

Baxdrostat, an aldosterone reducer.

Inhibiting aldosterone synthase presents a promising approach to treating hypertension. However, it is key to ensure selective inhibition to avoid compromising cortisol production. Recently, researchers have identified Baxdrostat as a highly selective AS inhibitor that does not interfere with cortisol synthesis. The specificity of Baxdrostat in inhibiting aldosterone synthase over cortisol synthase is 100:1.

Baxdrostat clinical trial.

The findings of a phase 2 BrigHTN clinical trial were published in the New England Journal of Medicine in February 2023. This study aimed to compare the efficacy of Baxdrostat with a placebo in treating patients with difficult-to-control hypertension. The primary endpoint was the change in systolic blood pressure from baseline to week 12. The trial involved approximately 250 patients who completed the study. 

Results of the trial.

The results showed a clinically significant decrease in systolic blood pressure ranging from 8-11 mmHg in the Baxdrostat group compared to the placebo group. Notably, no instances of adrenocortical insufficiency were observed in individuals receiving Baxdrostat, and the side effect profile was similar between the two groups.

Summary.

Baxdrostat is effective in reducing blood pressure in patients with resistant hypertension. This represents a significant stride towards obtaining FDA approval for Baxdrostat as a treatment for individuals who urgently require successful control of stubborn hypertension.

Dr. Tashko