The First New Anti-Hypertension Medication in Over 10 Years

Although there are multiple anti-hypertensive medications in clinical practice, there 

has not been a new entry into the field in over 10 years.  Many generics have hit the market as the 

expiration of patents continues to roll along.  It is exciting to know there is a new drug that   

shows promising benefits in treating hypertension in patients who show resistance to traditional 

medications   The drug targets the production of aldosterone, and it falls under the category of 

aldosterone synthetase inhibitor.  Lorundrostat (Mineralys Therapeutics) lowered office systolic BP 

significantly more than placebo. The greatest effects were seen in patients with obesity.  The results of 

the Target-HTNstudy were released in September this year.  Excessive aldosterone production contributes to 

uncontrolled hypertension in patients with obesity and other associated diseases, such as obstructive 

sleep apnea and metabolic syndrome.  A second medication in the same category is baxdrostat  (Astra

 Zeneca) 

Both these medications appear to lower blood pressure both in patients with and without an increase in their 

plasma renin activity which has been a problem for other medications in the past.  An author of 

an editorial in JAMA  noted that more than 70 years after the first isolation of aldosterone, “there is a 

new dawn for therapies targeting aldosterone.”  It is now thought that there is real potential to provide 

better targeted treatments for patients in whom aldosterone excess is known to contribute to their

clinical condition. Lorundrostat (50 and 100 mg tablets) is still awaiting FDA approval and it is not clear

when that may be. This same medication is also produced by AstraZeneca under the name of 

“baxdrostat”.