New drugs for the treatment of resistant hypertension: nonsteroidal mineralcorticoid receptor antagonist finerenone and aldosterone synthase inhibitor baxdrostat

The inclusion of spironolactone in antihypertensive therapy does not provide blood pressure (BP) control in the significant proportion of patients with resistant hypertension (HTN) and is accompanied by an increased risk of developing of hyperkalemia and complications associated with blockade of male and female sex hormone receptors. In this regard, a search is underway for new drugs that are not only capable of effectively controlling BP in this population, but also have a more favorable safety profile than their predecessors. The most promising are new drugs that selectively suppress the activity of aldosterone synthase-aldosterone-mineralcorticoid receptor hormonal system, the excessive activity of which underlies the formation of resistant HTN. The review presents data on the characteristics of pharmacokinetics and the results of the clinical studies obtained in patients with resistant HTN when assessing the effectiveness and safety of the use of the new nonsteroidal mineralcorticoid receptor antagonist finerenone and the selective aldosterone synthase inhibitor baxdrostat.