High blood pressure is a leading cause of serious health problems. It increases the risk of heart attacks, strokes, heart failure, kidney disease, and early death.
Although many medications are available, some people continue to have dangerously high blood pressure even after taking several drugs. Researchers have been searching for new ways to help these patients, and a surprising discovery suggests that one of the answers may lie in a tiny organ hidden in the neck.
Scientists from the University of Bristol have found that a small structure called the carotid body may play a much bigger role in blood pressure control than previously thought. Their research suggests that this tiny organ could be an important cause of high blood pressure in some people and may become a target for future treatments.
The study was led by Professor Julian Paton and Dr. Angus Nightingale and was published in JACC: Basic to Translational Science. The researchers focused on people with resistant hypertension, a condition in which blood pressure remains high despite the use of multiple medications.
The carotid body is extremely small, about the size of a grain of rice. Each person has two carotid bodies, one on each side of the neck. They are located near the carotid arteries, which are major blood vessels that carry blood from the heart to the brain.
For many years, scientists knew that the carotid body acts as a sensor that monitors oxygen levels in the blood. When oxygen levels fall, the carotid body sends signals to the brain. In response, the body increases breathing and raises blood pressure to ensure that enough oxygen reaches important organs.
This response is very useful during emergencies. For example, it helps the body react when oxygen levels suddenly drop. However, researchers suspected that in some people the carotid body becomes overactive and keeps sending signals even when oxygen levels are normal.
Professor Paton compares this problem to a thermostat that is set too high. Instead of turning off when the room is warm enough, it keeps producing heat. Similarly, an overactive carotid body may keep telling the body to raise blood pressure when there is no real need to do so.
To test this idea, the research team conducted a clinical trial involving patients with resistant high blood pressure. The treatment was unusual. Surgeons removed just one of the two carotid bodies.
The results were remarkable. Blood pressure dropped immediately after the procedure and remained lower over time. According to Dr. Nightingale, the reduction in blood pressure was greater than what doctors would normally expect from many medications.
These findings suggest that the carotid body may be a major driver of high blood pressure in certain individuals. More importantly, the study showed that targeting this small organ could provide a new way to treat people who do not respond well to standard therapies.
The researchers also developed special tests to identify which patients were most likely to benefit. They found that people with overactive carotid bodies shared certain characteristics. They tended to breathe more rapidly while resting and showed stronger responses when oxygen levels were slightly reduced.
Patients with these signs experienced the largest improvements after surgery. This finding opens the door to more personalized treatment. Instead of using the same approach for everyone, doctors may eventually be able to identify patients whose blood pressure problems are being driven by an overactive carotid body and offer targeted therapy.
High blood pressure remains a major challenge worldwide. Many people do not realize they have it because symptoms are often absent. This is why hypertension is sometimes called a “silent killer.” Over time, uncontrolled high blood pressure can damage blood vessels and vital organs without causing noticeable warning signs.
In the United Kingdom alone, high blood pressure costs the healthcare system around £2 billion every year. Similar economic and health burdens exist in countries across the world.
Although the surgery produced encouraging results, researchers do not believe that removing a carotid body will become a routine treatment for most patients. Surgery carries risks and is not suitable for everyone.
Instead, the scientists hope to develop medications that can calm an overactive carotid body without removing it. This would allow patients to receive the benefits of treatment without undergoing an operation.
Their search for such a drug has already produced promising results. In a separate animal study, the team discovered that a molecule called adenosine triphosphate, or ATP, plays an important role in carotid body activity. ATP is often known as the molecule that stores and transfers energy inside cells, but it can also act as a signaling chemical.
The researchers identified a receptor called P2X3 within the carotid body. This receptor responds to ATP signals. By blocking the receptor, they were able to reduce the excessive alarm signals being sent to the brain while still allowing the carotid body to continue performing its normal functions.
This approach could eventually lead to a completely new class of blood pressure medications. In fact, researchers note that there has not been a major new type of blood pressure drug introduced in more than 15 years.
The discovery is the result of nearly a decade of work involving researchers and medical centers from the United Kingdom, Poland, the United States, Brazil, and New Zealand. The project also received support from the British Heart Foundation.
The findings highlight how a tiny organ that many people have never heard of may have a major influence on cardiovascular health. By focusing on the underlying causes of high blood pressure rather than simply treating the symptoms, scientists hope to create more effective and personalized therapies in the future.
If further studies confirm these results, targeting the carotid body could become an important new strategy for helping millions of people whose blood pressure remains difficult to control.
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The study was published in JACC: Basic to Translational Science.
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