A major medical breakthrough from researchers in the United Kingdom may change the way doctors treat high blood pressure.
Scientists have developed a new type of CT scan that can quickly and safely identify tiny hormone-producing nodules in the adrenal glands, potentially allowing many patients to be cured instead of taking blood pressure medicine for life.
The new research was carried out by scientists and doctors from Queen Mary University of London, Barts Hospital, and Cambridge University Hospital. Their findings were published in the journal Nature Medicine.
High blood pressure, also called hypertension, affects millions of people around the world and is one of the leading causes of heart attacks, strokes, kidney disease, and early death. In many cases, doctors do not know exactly what causes a person’s blood pressure to become dangerously high.
However, scientists now understand that some people develop high blood pressure because of a hormone problem involving the adrenal glands. These small glands sit above the kidneys and produce important hormones that help control blood pressure, metabolism, stress responses, and salt balance.
One hormone produced by the adrenal glands is called aldosterone. This hormone helps the body control salt and water levels. When too much aldosterone is produced, the body holds onto extra salt and water, causing blood pressure to rise.
Researchers estimate that around one in ten people with high blood pressure may have a condition called primary aldosteronism, where one or both adrenal glands produce too much aldosterone. In many patients, the problem is caused by tiny nodules, or small lumps, in the adrenal gland tissue.
These nodules are often extremely small and difficult to detect using standard imaging scans. As a result, many patients remain undiagnosed for years while continuing to struggle with difficult-to-control high blood pressure.
Until now, the only reliable way to locate the overactive adrenal gland involved a complicated procedure called adrenal vein sampling. During this test, doctors insert catheters into veins connected to the adrenal glands to measure hormone levels directly.
This procedure is technically difficult, uncomfortable for patients, and available only in a limited number of specialist hospitals. Even then, the results are not always clear.
The new CT scanning method may change that completely.
The scan uses a special radioactive dye called metomidate. This dye attaches specifically to the overactive adrenal nodule that is producing excess aldosterone. When doctors perform the scan, the faulty nodule lights up clearly, allowing doctors to easily identify the exact source of the hormone problem.
According to the researchers, the scan is fast, safe, painless, and much simpler than previous testing methods.
The research team tested the scan in 128 patients who had high blood pressure linked to elevated aldosterone levels. The results were highly encouraging.
The scan successfully identified overactive nodules in every patient included in the study. In about two-thirds of patients, only one adrenal gland was affected. This is important because if only one gland is causing the problem, doctors can remove the faulty gland through surgery.
For many patients, this surgery may effectively cure their high blood pressure.
In the study, 18 out of 24 people who underwent surgery were able to stop taking blood pressure medications completely afterward. Many others also saw major improvements in their blood pressure control.
Researchers found that combining the scan with a simple urine test made the results even more powerful. Together, the tests helped doctors predict which patients were most likely to be cured by surgery.
This could allow doctors to provide more personalized treatment instead of relying on years of trial-and-error medication adjustments.
Professor Morris Brown, one of the lead researchers, explained that these hormone-producing nodules are often too tiny to appear on regular scans. However, with the new imaging method, they become clearly visible for a short period after the injection of the special dye.
He believes the scan could soon become widely available in hospitals and help many more patients receive proper diagnosis and treatment.
Professor William Drake, another senior researcher involved in the project, praised the large team of scientists and healthcare workers who contributed to the research, especially during the challenges of the COVID-19 pandemic.
Experts say the findings could represent a major shift in the treatment of hypertension. Currently, many people with high blood pressure take medication for decades without knowing the underlying cause of their condition. Some patients require several medications and still struggle to control their blood pressure.
If doctors can identify patients whose hypertension is caused by a small adrenal gland nodule, some of these individuals may instead be treated with a single surgery that removes the root cause of the problem.
This could not only improve quality of life but also reduce the long-term risk of serious complications such as heart attacks, strokes, kidney failure, and heart disease.
The researchers are hopeful that the new scan will soon become part of routine medical care for patients with difficult-to-control high blood pressure.
Although further research and broader hospital adoption are still needed, the study offers hope that many people who currently depend on lifelong medication may one day have the opportunity for a permanent cure.
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