A Study to Assess the Efficacy and Safety of Lorundrostat in Participants With Obstructive Sleep Apnea and Hypertension

Eligibility Criteria

• 1. Body mass index (BMI) ≥ 27 kilograms per meter square (kg/m\^2)
• 2. Previously diagnosed with moderate-to-severe OSA
• 3. AHI ≥15 events per hour (/hr) prior to Randomization
• 4. AOBP SBP of ≥130 and less than or equal to (≤) 160 millimeter of mercury (mmHg) and AOBP diastolic blood pressure (DBP) ≥60 and ≤110 mmHg
• 5. Participants on CPAP or PAP therapy are eligible provided they are on PAP for ≥4 hours per night and for at least 3 months prior to the study enrollment
• 6. Participants not currently on PAP therapy, and not anticipated to start PAP for the duration of the study
• 7. Fertile male and female participants of childbearing potential, and their partners, must agree to use protocol-defined methods of highly effective contraception from the Screening Visit until 28 days after the last dose of study drug
• 1. Type 2 diabetes mellitus (T2DM) with a glycosylated hemoglobin (HbA1c) greater than (\>) 9 percent (%) (\>74.9 millimoles per mol \[mmol/mol\]) at the Screening Visit or history of diabetic ketoacidosis in the 6 months prior to the Screening Visit
• 2. Participants on a glucagon-like peptide-1 (GLP-1) agonist.
• 3. Any planned surgery for sleep apnea or major ear, nose or throat surgery, including tonsillectomy and adenoidectomy during trial participation.
• 4. Have diagnosis of central or mixed sleep apnea with % of mixed or central apneas/hypopneas ≥50%, or diagnosis of Cheyne Stokes Respiration
• 5. Diagnosis of Obesity Hypoventilation Syndrome or daytime hypercapnia
• 6. Use of bilevel positive airway pressure (BiPAP) therapy.
• 7. History of clinically significant hyponatremia within 1 year prior to Screening
• 8. eGFR less than (\<) 45 milliliter per minute per 1.73 meter square (mL/min/1.73 m\^2) at Screening
• 9. History of clinically relevant medical, behavioral, or psychiatric disorder, other than OSA, that is associated with insomnia or excessive sleepiness
• 10. Diagnosed with Child-Pugh Class C
• 11. Participants who regularly use caffeine stimulants or participants who are unwilling to reduce intake to 300 mg per day (approximately 3 cups of coffee), 1 week prior to Screening
• 12. Treatment with MRAs and/or epithelial sodium channel (ENaC) inhibitors within 1 month of the Screening Visit
• 13. Use of supplemental oxygen
• 14. Women who are pregnant, plan to become pregnant, or are breastfeeding
• 15. Hospitalization for the treatment of urgent or emergent hypertension within 1 year prior to Screening
• 16. Unstable or currently symptomatic cardiovascular disease or hospitalization in the 6 months prior to Screening
• 17. Previously diagnosed, recurrent orthostatic hypotension
• 18. Current night-shift worker or anticipated to become a night-shift worker for 3 days continuously during the duration of the study
• 19. Classified as a New York Heart Association (NYHA) Class III or IV at the Screening Visit