Doctors in the UK have tested a new 20-minute treatment that could offer some people with high blood pressure an alternative to surgery. The procedure targets tiny growths in the adrenal glands that can cause blood pressure to rise.
The research, involving Queen Mary University of London, Barts Health NHS Trust, University College London and other UK centers, was published in The Lancet. The treatment is called Targeted Thermal Therapy, or Triple T.
Most high blood pressure does not have one single cause. But about one in 20 people with hypertension may have a condition called primary aldosteronism, in which the adrenal glands make too much of a hormone called aldosterone.
The adrenal glands are small organs that sit above the kidneys. Aldosterone helps the body control salt and water, but too much of it can make the body hold on to extra salt, pushing blood pressure higher.
Primary aldosteronism is important because it can sometimes be cured. Yet the condition is often missed, and researchers say fewer than one percent of affected people are diagnosed.
In some patients, the problem comes from a small, non-cancerous growth in one adrenal gland. This growth produces too much aldosterone and can make high blood pressure difficult to control with standard medicines.
People with the condition also face higher risks of serious health problems, including heart attacks, strokes and kidney damage. Until recently, the main curative treatment for a growth in one adrenal gland was surgery to remove the whole gland.
Triple T takes a very different approach. Instead of removing the adrenal gland, doctors use a tiny device that produces heat to destroy only the abnormal growth while leaving the rest of the gland in place.
The device is guided through the mouth and into the digestive system, in a procedure similar to an endoscopy. Ultrasound helps doctors locate the adrenal growth, and a small needle delivers heat directly to it without making an external surgical cut.
The treatment takes about 20 minutes and avoids major surgery and its longer recovery period. Recent advances in medical imaging have also made it easier for doctors to identify the small adrenal growths that need to be treated.
The first study of the technique, called FABULAS, included 28 patients with aldosterone-producing adrenal growths. Six months after treatment, most had hormone levels return to normal, and some were able to stop taking blood pressure medicines.
The researchers also reported no return of the condition during the study period. However, the trial was small and was mainly designed to test whether the new procedure could be performed safely and successfully, so larger studies are needed before it can replace surgery.
Professor Morris Brown of Queen Mary University of London said the approach could help fulfill a long-standing goal of finding and treating curable causes of high blood pressure. For patients, avoiding removal of an entire adrenal gland could mean a simpler procedure and a faster return to everyday life.
A larger trial called WAVE is now comparing Triple T directly with traditional adrenal surgery in 120 patients. Its results are expected in 2027 and should provide a clearer picture of how well the new treatment works over a longer period.
If those results are positive, Triple T could eventually be offered in specialist endoscopy units in many countries. That could make treatment easier to access for people whose high blood pressure is being driven by an adrenal growth.
The findings also highlight the importance of identifying the cause of difficult-to-control high blood pressure. For a small but significant group of patients, hypertension may not simply be a lifelong condition to manage with pills, but a problem that doctors may be able to treat at its source.
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