Doctors at Queen Mary University of London, Barts Health NHS Trust, and University College London have developed a simple, minimally invasive procedure that could dramatically change the way a common cause of high blood pressure is treated.
The new approach, called Targeted Thermal Therapy (Triple T), could provide an effective alternative to surgery and help millions of people worldwide who currently go undiagnosed and untreated.
Published in The Lancet, this breakthrough was tested in the UK in collaboration with major universities and hospitals, including Cambridge and University College London.
One lesser-known cause of high blood pressure is primary aldosteronism, which affects about one in twenty people with hypertension. Unfortunately, fewer than one percent of those affected are ever diagnosed.
The condition is caused by small, non-cancerous growths in the adrenal glands that produce too much of the hormone aldosterone. This hormone raises blood pressure by increasing salt in the body. These patients often don’t respond well to standard medications and are at greater risk for heart attacks, strokes, and kidney failure.
Until now, the only way to cure this condition was to remove the entire adrenal gland through surgery, which requires general anesthesia and a lengthy recovery. Because of this, many people simply go untreated.
Triple T changes that. The new treatment uses recent advances in imaging and a tiny heat-emitting needle to destroy the hormone-producing nodule without removing the entire gland.
The procedure is guided by ultrasound and performed through the mouth, similar to a regular endoscopy. It takes about 20 minutes and doesn’t require any cuts, making it safer and easier for patients to recover.
In the FABULAS study, which tested Triple T in 28 patients, most saw normal hormone levels just six months after treatment. Many were able to stop taking blood pressure medication altogether, with no return of the condition.
The trial was named after its full title: Feasibility study of radiofrequency endoscopic ablation, with ultrasound guidance, as a non-surgical, adrenal-sparing treatment for aldosterone-producing adenomas.
Professor Morris Brown of Queen Mary University of London said the new treatment could finally make good on a decades-old prediction that many cases of high blood pressure could be traced to and cured by treating adrenal nodules.
One patient, Michelina Alfieri, shared how the treatment relieved her years-long struggle with headaches and allowed her to quickly return to normal life.
Following the success of FABULAS, a larger clinical trial called ‘WAVE’ is now underway. It will compare Triple T to traditional surgery in 120 patients, with results expected in 2027.
Experts believe the treatment could become widely available in endoscopy units around the world. With further validation, this method could replace surgery for many patients, leading to faster recovery times and better long-term health outcomes.
This promising advance was made possible by new PET imaging technology that helps doctors pinpoint adrenal nodules without invasive procedures. It also received support from Barts Charity, the British Heart Foundation, and the National Institute for Health and Care Research (NIHR).
If future trials are successful, Triple T may soon become a standard treatment for a curable form of high blood pressure, improving the lives of countless people.
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The study is published in The Lancet.
