Q3 2025 Recap: Cardiology News and Updates

The third quarter of 2025 saw a series of revolutionary changes in cardiology, with major regulatory updates, significant new trail data, and the release of new guidelines in hypertension and heart failure (HF).

The US Food and Drug Administration (FDA) approved bumetanide nasal spray for congestive HF, which represents an entirely new uptake pathway for cardiovascular medication, and finerenone for HF with preserved ejection fraction (HFpEF) ≥40%, filling a critical need in a growing at-risk population.

Q3 also saw major advancements in the cardiology pipeline, with the achievement of primary endpoints for both baxdrostat and mavacamten. Even the failed VICTOR trial of vericiguat brought about meaningful updates, indicating the drug’s efficacy in reducing cardiovascular mortality, all-cause mortality, sudden cardiac death, and HF-related death.

The editorial team at HCPLive has collected some of the most impactful headlines from Q3 of 2025 – check them out below:

FDA News

FDA Approves Bumetanide Nasal Spray for Edema with Congestive Heart Failure

On September 15, 2025, the FDA opened an unexplored pathway for cardiovascular disease treatment with their approval of bumetanide nasal spray. Designed to reduce edema in patients with congestive HF, liver disease, and chronic kidney disease, this spray is the first intranasal loop diuretic in cardiology and could potentially enable earlier – and possibly outpatient – intervention in HF treatment.

FDA Approves Finerenone (Kerendia) for Heart Failure with Ejection Fraction of 40% or More

On July 14, 2025, finerenone became a major factor for HFpEF care alongside SGLT2 inhibitors, indicated for reducing the risk of cardiovascular death, HF hospitalization, and urgent HF visits for adults with heart failure with mildly reduced ejection fraction (HFmrEF) and HFpEF. The FDA approval significantly expanded treatment options for HF patients with a left ventricular ejection fraction ≥40%, which is a consistently growing and significantly at-risk population.

Guideline Updates

AHA & ACC Release New Guidelines for High Blood Pressure to Reduce CVD Risk

In August 2025, the American Heart Association and the American College of Cardiology released a joint guideline to encourage physical activity, heart-healthy diets, and stress management for the reduction of hypertension. Given the condition’s prevalence in diseases across various specialties, including kidney disease, diabetes, dementia, and HF, the new guidelines aim to support clinicians at every level in consistently and accurately monitoring their patients’ blood pressure.

Related: ACC/AHA Hypertension Guideline Update: Recommendations for Managing Blood Pressure

HFSA and ASPC Release Statement on Shifting to Prevention in Heart Failure

Also in August 2025, the Heart Failure Society of America and the American Society for Preventive Cardiology released a joint statement calling for a change in how HF treatment is approached. The statement encourages clinicians to view HF as a preventable condition rather than an inevitable outcome of cardiovascular disease. The authors provide a detailed framework suggesting preventive strategies for all stages of HF, independent of ejection fraction, as well as strategies for patients with established diseases and those with advanced therapies like heart transplants.

Related: HFSA/ASPC Heart Failure Prevention: From Prognosis to Prevention in Heart Failure

Trial Updates

Baxdrostat Meets Efficacy Endpoint in Phase 3 Trial for Resistant Hypertension

On July 14, 2025, parent company AstraZeneca announced positive topline results from the BaxHTN trial, showing baxdrostat’s capacity for lowering aldosterone in patients with treatment-resistant hypertension. The oral small molecule was administered once daily to patients in a range of doses, all of which efficaciously inhibited ASI to reduce aldosterone production without impacting cortisol levels.

Related:Bax24: Baxdrostat Achieves Primary Endpoint in Treatment-Resistant Hypertension

Don't Miss a Beat: Vericiguat in Heart Failure and the VICTOR Trial, With Javed Butler, MD

Although the VICTOR trial failed to achieve its primary endpoint, vericiguat did prove itself efficacious in reducing several mortality endpoints. This episode of Don’t Miss a Beat follows cohosts Stephen Greene, MD, and Muthiah Vaduganathan, MD, MPH, as they sit down with Javed Butler, MD, to review the trial’s results and where future trials can go from here.

Aficamten Outperforms Metoprolol in Obstructive Hypertrophic Cardiomyopathy, With Pablo Garcia-Pavia, MD, PhD

The MAPLE-HCM trial, the results of which were presented at the European Society of Cardiology (ESC) Congress 2025, saw aficamten demonstrate superior clinical and functional benefits compared to metoprolol in symptomatic obstructive hypertrophic cardiomyopathy (HCM). At the end of the 24-week study period, patients assigned to aficamten saw substantial improvements to left ventricular outflow tract gradients, NT-proBNP levels, and left atrial volume index, among other factors in HCM.

COLLIGO-HCM: Mavacamten (CAMZYOS) Effective in Obstructive HCM With Pankaj Arora, MD

Mavacamten, the first and only cardiac myosin inhibitor to receive FDA approval for adults with class II-III obstructive HCM, proved its safety and efficacy in the COLLIGO-HCM trial by parent company Bristol Myers Squibb. The results challenge the broad application of beta blockers and calcium channel blockers, as it provides patients with continued symptoms and elevated gradients with an alternative method of myosin innovation.