Baxfendy (Baxdrostat): A New Drug for High Blood Pressure

For people living with diabetes, managing blood sugar is just one part of protecting long-term health. When blood sugar and blood pressure both run high, the risk of long-term complications, such as vision loss, heart disease, and kidney disease, climbs sharply. 

Even with lifestyle changes and multiple medications, blood pressure can be difficult to manage. This challenge has pushed researchers to look beyond traditional therapies targeting blood vessels or fluid balance and explore the hormonal systems that drive high blood pressure (hypertension). 

According to the American Diabetes Association, high blood pressure is defined as 130/80 mmHg or higher and affects many adults worldwide. While several types of blood pressure medications exist, such as ACE inhibitors, ARBs, diuretics, and calcium channel blockers, millions of people still struggle to keep their blood pressure in range. When high blood pressure doesn’t respond to the usual medications, this condition is known as resistant hypertension. Finding new routes to treat resistant hypertension is an urgent priority for both people with diabetes and the general population.

Approved by the FDA in May 2026, Baxfendy (baxdrostat) offers a new approach for people with treatment-resistant hypertension, including those living with diabetes who face heightened risks.

What is baxdrostat?

Baxdrostat, an aldosterone synthase inhibitor, is an oral, once-daily pill designed to reduce blood pressure by targeting a hormone called aldosterone, which is one of the body’s key regulators of salt and water balance.

While most blood pressure drugs work by blocking the effects of hormones like angiotensin or aldosterone, baxdrostat works by blocking the production of aldosterone itself. Aldosterone tells your kidneys to hold onto salt and water, which may increase blood volume and raise blood pressure. Baxdrostat prevents your adrenal glands from making as much of this hormone, which in turn helps the body release excess salt and water and lowers pressure in the arteries.

In other words, when your kidneys are getting constant messages to hold on to salt, baxdrostat turns down the volume on these signals, helping your body get rid of excess salt and water.

The recommended dosage of Baxfendy is 2 mg orally once daily. For patients at increased risk of high blood potassium (hyperkalemia) or low blood sodium levels (hyponatremia), the recommended dosage is 1 mg orally once daily.

What does the research say?

Studies have shown Baxfendy (baxdrostat) to be effective for people with treatment-resistant or difficult-to-manage hypertension. A large phase 3 trial called BaxHTN showed that participants taking 1-2 mg of baxdrostat daily had an average reduction of 8-10 mmHg in their blood pressure after 12 weeks. 

Other studies have also shown that baxdrostat can selectively block aldosterone production without significantly affecting cortisol, another adrenal hormone essential for normal body function. In a smaller study analyzing the effects of baxdrostat on metformin in healthy individuals, researchers suggested that baxdrostat may be safe to use with common diabetes medications.

These positive findings are what led to baxdrostat's approval, making it a new option for people whose blood pressure remains high despite standard therapy. For those with diabetes, better management of blood pressure translates directly into lower risks of heart, kidney, and eye complications.

Currently recruiting trials

If you or someone you know has high blood pressure that’s been difficult to manage, there are ongoing baxdrostat clinical trials currently recruiting participants.

The BaxDuo-Pacific trial is evaluating the combination of baxdrostat and dapagliflozin (Farxiga) in adults with chronic kidney disease and high blood pressure. If you have type 1 diabetes and have been treated with an SGLT-2 inhibitor for at least four months (without diabetic ketoacidosis during that period), you may be eligible for this study. 

Similarly, the Prevent-HF trial is comparing the combination of baxdrostat and dapagliflozin to dapagliflozin alone in adults with type 2 diabetes who are at least 40 years old. 

Learn more about blood pressure and diabetes here:

• Expert Tips for Kidney and Heart Health
• How To Take Care of Your Heart With Diabetes
• The DASH Diet: A Heart-Healthy Eating Plan

This content was made possible through a grant from AstraZeneca. diaTribe maintains final editorial discretion.