Summary: Clinical studies conducted over the past six decades have not only uncovered the complex mechanisms of aldosterone's action in physiological and pathophysiological conditions but have also established the role of this hormone in the pathogenesis of CV disease. Classic clinical examples of the effects of excessive aldosterone on the renal system and kidneys include primary aldosteronism, uncontrolled and resistant hypertension, obstructive sleep apnea, heart failure, and chronic kidney disease. Over the past 4 years, the results of studies using new selective aldosterone synthase inhibitors have been published, particularly baxdrostat, the first highly selective aldosterone synthase inhibitor, in patients with uncontrolled and resistant hypertension. This drug significantly and dose-dependently reduced both systolic and diastolic BP compared to placebo without affecting cortisol synthesis. These results are extremely promising, as aldosterone synthase inhibitors are significantly more effective in inhibiting the action of aldosterone than currently available drugs, and they also inhibit the rapid, non-genomic effects of this hormone's action. Aldosterone synthase inhibitors will represent a new, very interesting treatment option for hypertension. According to US recommendations they can be used in the treatment of hypertension in combination with other antihypertensive drugs to lower BP in adults whose condition cannot be adequately controlled with currently available drugs.