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New Drug Lowers BP, But Raises Hyperkalemia Risk
31 Mar
Summary
- Lorundrostat effectively lowers systolic blood pressure.
- Higher doses of lorundrostat increase hyperkalemia risk.
- Future trials needed to confirm real-world safety and efficacy.
Lorundrostat is emerging as a potential late-line treatment for uncontrolled or resistant hypertension. A recent meta-analysis presented at the 2026 American College of Cardiology Scientific Session in New Orleans evaluated three randomized controlled trials involving 1,060 patients. The study found that lorundrostat significantly reduced systolic blood pressure, with the 100 mg dose showing a reduction of 11.41 mm Hg and the 50 mg dose showing a reduction of 9.08 mm Hg compared to placebo.
Despite its blood pressure-lowering efficacy, lorundrostat is linked to a higher risk of hyperkalemia. This adverse event was more frequent in patients taking lorundrostat than in the placebo group, with the risk escalating at the 100 mg dose. Experts suggest that while lorundrostat offers a targeted approach to aldosterone-driven hypertension, careful patient selection and monitoring protocols will be crucial for its safe implementation.
Future large-scale phase III trials and long-term safety studies are anticipated to clarify lorundrostat's precise role in treatment algorithms. These investigations will focus on managing hyperkalemia risks and confirming benefits in high-risk patient groups, including those with chronic kidney disease. If successful, lorundrostat could become a valuable option for resistant hypertension, though its uptake may be cautious due to the observed safety signal.
