Doctors at Queen Mary University of London, Barts Health NHS Trust, and University College London have developed a minimally invasive procedure called Targeted Thermal Therapy (Triple T) to treat a hidden cause of high blood pressure — primary aldosteronism.
This condition often goes undiagnosed but affects about 5% of hypertensive patients.
Primary aldosteronism occurs when benign adrenal gland nodules overproduce aldosterone, a hormone that increases salt retention, blood pressure, and risks of cardiovascular and kidney complications.
Traditionally, treatment required surgical removal of the adrenal gland, a procedure involving hospitalisation and extended recovery.
Triple T offers a groundbreaking alternative by targeting and ablating the nodule using radiofrequency energy guided by endoscopic ultrasound. This procedure, which takes just 20 minutes, is done through the mouth and requires no incisions. The treatment selectively destroys the nodule while preserving healthy adrenal tissue.
The FABULAS trial, involving 28 patients, showed promising results. Most participants had normalized hormone levels six months post-treatment, with many discontinuing blood pressure medications. The therapy was safe, effective, and enabled rapid recovery.
Following the trial’s success, a larger randomized clinical study, WAVE, is now underway and aims to confirm the benefits of Triple T versus traditional adrenal surgery. Results are expected in 2027.
Experts say this new procedure could revolutionize hypertension care globally. With further testing and training, it has the potential to become a standard non-surgical option in hospitals worldwide, providing hope to millions with curable hypertension.
The study is published in Circulation Research.
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