Researchers have discovered that a common form of high blood pressure is caused by tiny, non-cancerous growths in the adrenal glands.
These small nodules, found in about 1 in 20 people with hypertension, produce too much of a hormone called aldosterone, which controls the amount of salt in the body.
The excess salt leads to high blood pressure, making the condition difficult to manage with standard treatments.
The study, published in Nature Genetics, reveals that a specific gene variant in some of these nodules causes a major, but unpredictable, increase in aldosterone levels. This makes it difficult for doctors to diagnose affected patients using standard tests.
Aldosterone helps regulate salt and water balance in the body. When too much of it is produced, the body retains extra salt, raising blood pressure.
Patients with excessive aldosterone often do not respond well to common blood pressure medications and are at higher risk of heart attacks and strokes.
Doctors have struggled to diagnose this condition because of how aldosterone is released—it fluctuates throughout the day. If a blood test happens when levels are low, the problem can go undetected.
The researchers suggest that measuring aldosterone over a full 24-hour period, using a urine test instead of a single blood test, would help identify more patients with this hidden form of hypertension.
One of the most exciting findings of this research is that the condition can be completely cured in some cases.
Removing one of the two adrenal glands (a procedure called unilateral adrenalectomy) has been shown to eliminate high blood pressure in affected patients. Those who underwent this surgery no longer needed medication, even years later.
The first patient in the study was identified when doctors noticed unusual fluctuations in his hormone levels during a clinical trial for hard-to-treat hypertension. This led researchers to investigate further, uncovering the gene mutation responsible for the excessive aldosterone production.
Fewer than 1% of people with aldosterone-related hypertension are currently diagnosed because aldosterone is not routinely tested. This study highlights the need for better testing methods so more patients can receive the correct diagnosis and potentially curative treatment.
Professor Morris Brown, a co-senior author of the study from Queen Mary University of London, emphasized the importance of research in improving patient care. He noted that many patients agree to have their surgical samples analyzed, allowing researchers to understand how their condition developed and how to treat future patients.
Since the nodules found in this study were extremely small, researchers are now exploring whether targeted cauterization—briefly applying heat to destroy the nodule—could be a less invasive alternative to removing the entire adrenal gland.
This discovery could lead to major improvements in diagnosing and treating a common, yet often overlooked, cause of high blood pressure.
If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and eating eggs in a healthy diet may reduce risks of diabetes, high blood pressure.
For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing 12 foods that lower blood pressure.
The research findings can be found in Nature Genetics.
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