關于難控制高血壓<\/u><\/b>?<\/u>
高血壓是一種以血壓持續升高為特征的醫學疾病，影響全球約14億人^{[6],[21],[22]<\/sup>。長期高血壓可損傷血管及重要器官，增加心肌梗死、卒中、心衰和腎臟疾病等嚴重健康問題的風險^{[20],[21]<\/sup>。一項納入近60,000名患者、中位隨訪時間9.7年的觀察性研究顯示，24小時動態收縮壓每升高9.5 mmHg，全因死亡風險增加30%，心血管死亡風險增加41%^{[4]<\/sup>。研究還表明，夜間血壓升高與更高的心血管風險相關^{[8],[11]<\/sup>，且高血壓患者在清晨血壓激增期間發生心肌梗死、卒中和死亡等心血管事件的風險更高^{[2],[3]<\/sup>。<\/p> \n}}}}}

難控制（未控制和難治性）高血壓仍然是一項重大公共衛生挑戰^{[23]<\/sup>。在美國，即便接受生活方式干預及多種藥物治療，約50%已接受治療的高血壓患者仍未能實現血壓控制^{[7]<\/sup>。未控制高血壓指接受兩種及以上降壓藥物治療后血壓仍持續升高，而更嚴重的難治性高血壓則指接受三種及以上藥物治療后血壓仍無法控制^{[7],[21]<\/sup>。目前指南建議大多數高血壓患者的血壓控制目標為＜130\/80 mmHg ^{[21],[22]<\/sup>。<\/p> \n}}}}

醛固酮作為調控血壓的關鍵激素，通過促進鈉水潴留機制升高血壓，是難控制高血壓的重要致病因素^{[24],[25]<\/sup>。醛固酮水平升高，以及合并有肥胖、高鹽攝入量以及各種遺傳和繼發性疾病等因素^{[26]<\/sup>，與血壓控制不佳密切相關。若不及時治療，高血壓會顯著增加心血管及腎臟相關并發癥的風險^{[21],[22]<\/sup>。<\/p> \n}}}

Bax24 III期試驗^{[16]<\/sup>是一項隨機、雙盲、安慰劑對照、平行組研究，旨在評估在難治性高血壓受試者中，每天一次（QD）口服Baxdrostat 2mg相較安慰劑，降低動態收縮壓的療效，以及安全性和耐受性。試驗共納入218名患者，按1:1隨機分配，在12周的雙盲期內每日一次接受Baxdrostat 2mg或安慰劑治療。主要療效終點為第12周時24小時動態平均收縮壓較基線的變化。<\/p> \n}

其他次要終點包括評估在第12周時相較安慰劑，Baxdrostat在以下各方面的效果：夜間動態平均收縮壓較基線的變化、日間動態平均收縮壓較基線的變化、坐位收縮壓較基線的變化、24小時動態平均收縮壓降至130mmHg以下的受試者人數、24小時動態舒張壓較基線的變化、夜間動態平均舒張壓較基線的變化、日間動態平均舒張壓較基線的變化、坐位舒張壓較基線的變化，以及達到夜間收縮壓降幅超過10%的受試者人數。在12周的治療期和2周安全隨訪期內評估不良事件的發生。<\/p> \n

Baxdrostat是一種有望成為首創新藥的高選擇性、強效口服小分子藥物，可抑制醛固酮合酶^{[12]<\/sup>，該酶由 CYP11B2 基因編碼，負責腎上腺中醛固酮的合成^{[24]<\/sup>。臨床研究表明，Baxdrostat 可在較大劑量范圍內顯著降低醛固酮水平且不影響皮質醇水平^{[13],[27]<\/sup>。目前，該藥正在作為單藥療法針對高血壓^{[13]-[16]<\/sup>和原發性醛固酮增多癥^{[17]<\/sup>開展臨床試驗評估，以及與達格列凈聯合用于治療慢性腎臟病合并高血壓^{[18],[19]<\/sup>，及高危患者心力衰竭的預防^{[20]<\/sup>。<\/p> \n}}}}}}}

阿斯利康于2023年2月通過收購 CinCor Pharma 公司獲得 Baxdrostat。^{[28]<\/sup><\/p> \n}

關于阿斯利康在心血管、腎臟及代謝治療領域<\/u><\/b><\/p> \n

心血管、腎臟及代謝始終是阿斯利康從全球到中國深耕的重要治療領域和增長引擎。阿斯利康通過科學研究，深入了解心臟、腎臟和胰腺之間的潛在聯系，積極投身于創新藥物的研發，來有效保護器官，減緩甚至阻止疾病進展，最終讓再生療法成為可能。阿斯利康致力于通過更好地理解心血管、腎臟及代謝疾病之間的相互關聯，從疾病的驅動機制著手，為患者提供更早、更有效地檢測、診斷和治療方案，從而改善和挽救數百萬人的生命。<\/p> \n

阿斯利康（LSE\/STO\/Nasdaq: AZN）是一家科學至上的全球生物制藥企業，專注于研發、生產及營銷處方類藥品，重點關注腫瘤、罕見病以及包括心血管腎臟及代謝、呼吸及免疫在內的生物制藥等領域。阿斯利康全球總部位于英國劍橋，業務遍布超過125個國家，創新藥物惠及全球數百萬患者。更多信息，請訪問www.astrazeneca.com。<\/p> \n

聲明：<\/i>本文涉及尚未在中國大陸獲批的產品和適應癥，阿斯利康不推薦任何未被批準的藥品使用。<\/i><\/p> \n

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[18] ClinicalTrials.gov. A Phase III Study to Investigate the Efficacy and Safety of Baxdrostat in
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cincor-for-cardiorenal-asset.html<\/a>. Accessed October 2025. <\/span><\/p> <\/td> \n <\/tr> \n <\/tbody> \n <\/table> \n<\/div> \n
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