Two years after stopping the medication, my blood pressure is still normal! The new drug baxdrostat, which inhibits aldosterone, may be a new dawn for "surgery-free" treatment for certain patients with hypertension.

Millions of patients with high blood pressure could benefit from a new drug called baxdrostat. The drug showed results that shocked doctors: a common cause of high blood pressure was reversed years after patients stopped taking the drug.

The Guardian reported on the 8th that the blood pressure of patients participating in the study improved significantly during the course of taking 1 tablet of baxdrostat per day for 6 to 12 months. Surprisingly, however, these benefits persisted up to 2 years after stopping the drug, and some patients no longer even needed to take any blood pressure-lowering drugs, which means that the disease has the potential to be "cured."

Professor Morris Brown, a hypertension expert at Queen Mary University of London who led the study, said: "This result is very exciting." "Nearly a quarter of the patients stopped treatment completely and their blood pressure returned to completely normal."

More than 1 billion people worldwide suffer from hypertension. In 5 to 10 percent of cases, high blood pressure is caused by small nodules or benign tumors on the adrenal glands, which cause the adrenal glands to overproduce a hormone called aldosterone. Excess aldosterone signals the kidneys to retain salt, which can raise blood pressure.

Currently, the standard treatment for this condition, known as primary aldosteronism, is to surgically remove the affected adrenal gland. However, because other factors may also cause high blood pressure in patients, surgery may not be able to completely cure it.

Baxdrostat is an "aldosterone synthase inhibitor" (ASI) that can effectively inhibit this hormone that increases blood pressure. The drug was approved in the United States earlier this year for patients with high blood pressure that cannot be controlled by existing drugs. Currently, the UK's National Institute for Health and Care Excellence (NICE) is also conducting a review, which is expected to be provided through the National Health Service (NHS) next year.

Baxdrostat's potential curative effect came to light in a small study tracking 14 patients. These patients experienced dramatic improvements in blood pressure during the 3-month trial, and then continued and stopped taking the drug for 6 to 12 months. When doctors visited them for follow-up visits 2 years later, they found that their blood pressure was still at a low level. The results of this study have been published in the authoritative New England Journal of Medicine.

Mason Freeman, a professor of medicine at Harvard University who participated in this work, said that it is still too early to say that some patients have recovered, and larger trials are currently being conducted to seek answers; "If this effect is widespread and very long-lasting, the methods of diagnosing and treating these patients may change significantly." "As long as this disease is initially suspected, everyone can be treated with ASI first; if the response is good, invasive diagnostic procedures and surgeries can be avoided."

Brown had suspected the drug had the potential to cure primary aldosteronism, based on a mouse experiment 20 years ago. Experiments at the time showed that deleting the gene needed to make aldosterone led to the loss of cells that secrete large amounts of the hormone.

He speculates that baxdrostat has a similar effect. When drugs inhibit aldosterone, they trigger a surge in highly reactive molecules called "reactive oxygen species," which may selectively destroy abnormal cells that overproduce hormones.

"Those oxygen radicals are killing the cells and making them disappear," Brown said. "I think that's the underlying mechanism, and it's testable and we're working on it in the lab right now."