Doctors in the UK have developed a new, simple, and minimally invasive treatment that could revolutionize how a common but often overlooked cause of high blood pressure is treated. This breakthrough, known as Targeted Thermal Therapy (Triple T), could help millions of people worldwide who currently go undiagnosed and untreated.
A Hidden Cause of High Blood Pressure
High blood pressure affects one in three adults, yet a condition called primary aldosteronism is responsible for around 5% of these cases. Unfortunately, fewer than 1% of people with this condition are ever diagnosed.
Primary aldosteronism occurs when small, benign nodules in the adrenal glands produce too much of a hormone called aldosterone. This hormone raises blood pressure by increasing the body’s salt levels. People with this condition often do not respond well to standard blood pressure medications and face a higher risk of heart attacks, strokes, and kidney failure.
A New Alternative to Surgery
Until now, the only cure for primary aldosteronism was surgery to remove the entire adrenal gland. This required general anesthesia, a hospital stay of two to three days, and a long recovery period. As a result, many patients went untreated.
Triple T offers a safer, quicker alternative by targeting and destroying the small nodule while leaving the rest of the adrenal gland intact. Recent advancements in diagnostic scans have made it possible to locate these tiny nodules more accurately using special molecular dyes.
The treatment works by using a modified version of two well-established medical techniques. A tiny internal camera, similar to the one used in routine endoscopy, is inserted through the mouth into the stomach.
Using ultrasound imaging, doctors locate the adrenal gland, which sits close to the stomach. A fine needle is then guided directly into the nodule. Short bursts of heat, generated by radiofrequency or microwaves, destroy the malfunctioning tissue while leaving healthy surrounding areas unharmed.
This entire procedure takes just 20 minutes and requires no internal or external incisions, meaning patients can recover almost immediately.
Successful Trial Brings New Hope
The first study to test this technique, called FABULAS, involved 28 patients with primary aldosteronism. Each patient had a hormone-producing nodule in the left adrenal gland, identified through specialized scans.
The results were highly promising:
- The procedure was safe and effective.
- Most patients had normal hormone levels six months after treatment.
- Many participants were able to stop taking blood pressure medication entirely.
- There were no cases of the condition returning.
Professor Morris Brown, a co-senior author of the study and an expert in endocrine hypertension at Queen Mary University of London, noted that this research fulfills a prediction made decades ago.
In the 1950s, a doctor in the U.S., Jerome Conn, suggested that 10-20% of high blood pressure cases could one day be linked to curable nodules in the adrenal glands. This new technique may finally make widespread diagnosis and treatment a reality.
One of the study participants, Michelina Alfieri, shared her experience: “Before the study, I had severe headaches for years, despite multiple visits to my doctor.
As a single parent with a full-time job, my daily life was affected. After this non-invasive treatment, I recovered immediately and could return to my normal routine. I’m incredibly grateful for this option.”
What’s Next?
Following the success of FABULAS, a larger study called “WAVE” is now underway. This randomized trial will compare Triple T with traditional adrenal surgery in 120 patients, with results expected in 2027. If successful, this treatment could become widely available in endoscopy units across the UK and beyond.
Professor Stephen Pereira, the chief investigator of FABULAS, emphasized the potential of this breakthrough: “With proper training, this technique could be adopted worldwide, providing a less invasive option for patients suffering from high blood pressure due to adrenal nodules.”
Professor Mark Gurnell, a clinical endocrinology expert at the University of Cambridge, highlighted the importance of new diagnostic tools that made this study possible. “For the first time, we can precisely locate and treat adrenal nodules non-invasively,” he said.
“This means more people can be diagnosed and treated, reducing their risk of heart disease and other complications, and lowering their dependence on lifelong blood pressure medication.”
A Major Step Forward for Hypertension Treatment
For the millions of people suffering from undiagnosed primary aldosteronism, this research offers new hope. By replacing major surgery with a quick, incision-free procedure, Triple T could allow patients to recover faster and enjoy better long-term health.
With further trials underway, this breakthrough treatment could soon become a standard procedure worldwide, transforming care for patients with this curable form of high blood pressure.
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The research findings can be found in The Lancet.
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