Scientists have developed a new type of CT scan that can detect tiny nodules in the adrenal glands, which are responsible for causing high blood pressure in some patients.
The breakthrough, led by doctors from Queen Mary University of London, Barts Hospital, and Cambridge University Hospital, was published in Nature Medicine and could revolutionize treatment for many people with hypertension.
Solving a Longstanding Problem
For decades, doctors have struggled to accurately identify these hormone-producing nodules without using a difficult catheter test. This invasive test is available in only a few hospitals and often fails. Now, with this new scan, doctors can locate the nodules quickly, painlessly, and with great accuracy.
The study involved 128 people who had high blood pressure caused by excessive levels of the steroid hormone aldosterone. Researchers found that in about two-thirds of these patients, the extra aldosterone came from a benign nodule in just one of their adrenal glands. In these cases, removing the affected gland could cure their high blood pressure.
How the Scan Works
The new scan uses a special radioactive dye called metomidate, which only sticks to the aldosterone-producing nodule. When scanned, the affected gland lights up, allowing doctors to pinpoint the problem. Unlike the traditional catheter test, this scan was successful in every patient and provided results much faster.
One of the most exciting findings was that when the scan was combined with a simple urine test, doctors could predict which patients would be completely cured after surgery. The combination correctly identified 18 out of 24 patients who were able to stop taking blood pressure medications after their gland was removed.
What This Means for Patients
Currently, most people with high blood pressure do not know the exact cause, and they rely on lifelong medication to manage it. However, previous research has shown that up to 10% of people with high blood pressure actually have a gene mutation in their adrenal glands that leads to excessive aldosterone production.
This hormone causes the body to retain salt, increasing blood pressure and making it harder to treat with standard medications.
Professor Morris Brown, a co-senior author of the study, highlighted the importance of this discovery. “These nodules are tiny and easy to miss on a normal CT scan,” he said.
“But when they glow for a few minutes after our injection, they reveal themselves as the true cause of high blood pressure—one that can often be cured. Right now, 99% of these cases go undiagnosed because the tests are too difficult and not widely available. Hopefully, that is about to change.”
Professor William Drake, another senior author, emphasized the dedication behind the study. “This research was made possible by years of hard work and collaboration across the UK. Many research fellows put in incredible effort, even during the national pandemic emergency, to make this breakthrough possible,” he said.
A New Future for Hypertension Treatment
This discovery opens the door to more personalized treatment for people with high blood pressure. Instead of simply managing the condition with medication, some patients may now have the option to completely eliminate their high blood pressure by identifying and removing these hormone-producing nodules.
The researchers hope that the new scan will soon become widely available, allowing more people to benefit from this groundbreaking diagnostic tool. If implemented broadly, it could significantly reduce the number of people living with untreated or difficult-to-control high blood pressure, lowering their risk of heart attacks and strokes.
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The research findings can be found in Nature Medicine.
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