It’s hard to believe, but a tiny organ in your neck, about the size of a grain of rice, may be one of the key reasons why some people have high blood pressure.
This small structure is called the carotid body, and it sits between two major arteries that carry blood to your brain.
Scientists at the University of Bristol have now discovered that this tiny organ plays a big role in controlling blood pressure—and they may have found a way to treat hypertension by targeting it.
The study, published in the Journal of the American College of Cardiology: Basic to Translational Science, was led by Professor Julian Paton and Dr. Angus Nightingale. Their clinical trial tested a new treatment for people with resistant high blood pressure—a condition where medications don’t help enough.
The treatment involved removing just one of the two carotid bodies, and the results were surprising: the patients’ blood pressure dropped right away and stayed low.
Dr. Nightingale explained that the drop in blood pressure was even more impressive than what doctors usually see with medication. This suggests the carotid body might be one of the main reasons why blood pressure rises in some people—and that treating it directly could help those who haven’t responded to standard treatments.
So what exactly does the carotid body do? It’s like an internal sensor that monitors how much oxygen is in your blood. If oxygen levels drop, it sends a message to your brain to increase breathing and raise your blood pressure to improve oxygen delivery.
That’s helpful during emergencies—but in people with an overactive carotid body, it’s like having a thermostat that’s stuck too high. The system is constantly trying to increase pressure, even when it’s not needed.
Professor Paton said that most treatments for high blood pressure focus on the symptoms, like the heart, kidneys, or blood vessels.
But this new approach is different—it targets the root cause. Even better, the team has created special tests to find out which patients have overactive carotid bodies. That way, doctors can offer personalized treatment to the people who are most likely to benefit.
In their trial, the researchers found that the patients who responded best to the carotid body removal had signs of overactivity. They breathed more at rest and reacted strongly when oxygen levels were slightly lowered. These people saw the biggest improvements in their blood pressure after the surgery.
High blood pressure is a major global health problem. It’s the top risk factor for stroke, heart failure, and kidney disease. In the UK alone, it costs the health system about £2 billion every year and is often not well controlled.
Although the surgery worked, the researchers don’t think it’s a long-term solution for everyone. Their goal now is to develop a drug that can calm down an overactive carotid body without needing surgery.
Professor Paton’s team might already be on the right track. In a separate study on animals, they found that a molecule called ATP (adenosine tri-phosphate) plays a role in the carotid body’s activity.
They discovered a receptor in the carotid body called P2X3 that responds to ATP—and by blocking it, they were able to reduce the alarm signals without shutting the system down completely.
This discovery could lead to the first truly new type of blood pressure medicine in over 15 years. It took nearly a decade of international collaboration between universities and hospitals in the UK, Poland, the USA, Brazil, and New Zealand, and support from the British Heart Foundation.
Thanks to this work, scientists are closer than ever to offering a new, personalized way to treat high blood pressure—by starting with the tiniest organ in the body.
If you care about blood pressure, please read studies about why checking blood pressure while lying down is very important and lowering top blood pressure number to less than 120 mm Hg effectively prevents heart disease.
If you care about blood pressure, please read studies that turmeric and vitamin D may boost blood pressure control in type 2 diabetes and scientists find link between blood pressure drugs and bowel diseases.
The study is published in JACC: Basic to Translational Science.
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