Ten-minute scan helps detect and cure cause of high blood pressure
Doctors at Barts Health NHS Trust, in partnership with Queen Mary University of London, have led new research that could cure high blood pressure.
In the study, published in Nature Medicine, the team showed how a new type of CT scan can light up tiny nodules (or growths) in a hormone producing gland more easily and more accurately than existing tests. If these nodules are removed, it can effectively cure a person’s high blood pressure. These nodules are found in 1 in 20 people with high-blood pressure, meaning the new test could help millions of people, including the nearly 240,000 people in east London who are living with high blood pressure.
This new scan helps solve a 60-year-old problem of how to easily and safely find these nodules in a way that works and could replace the existing test which is only available in some hospitals and often doesn’t work properly.
The study involved 128 people – 105 of whom were patients at St. Bartholomew’s Hospital – who had high blood pressure (hypertension) caused by the steroid hormone aldosterone. The new scan found that two-thirds of patients’ high blood pressure was caused by elevated levels of aldosterone that was coming from a nodule in an adrenal gland. Safely removing these nodules helps reduce aldosterone levels, and in turn, reduces blood pressure levels.
The team also found that, using this scan to identify nodules, and carrying out a urine test at the same time can more accurately identify patients who can come off all their blood pressure medicines after treatment.
Professor William Drake, a consultant at St Bartholomew’s Hospital said: “In most people with hypertension (high blood pressure), the cause is unknown, and the condition requires life-long treatment by drugs. Previous research by the group at Queen Mary University discovered that in 5-10% of people with Hypertension the cause is a gene mutation in the adrenal glands, which results in excessive amounts of the steroid hormone, aldosterone, being produced. Aldosterone causes salt to be retained in the body, driving up the blood pressure. Patients with excessive aldosterone levels in the blood are resistant to treatment with the commonly used drugs for hypertension, and at increased risk of heart attacks and strokes.”
Professor Morris Brown, co-senior author of the study and Professor of Endocrine Hypertension at Queen Mary University of London, said: “These aldosterone-producing nodules are very small and easily overlooked on a regular CT scan. When they glow for a few minutes after our injection, they are revealed as the obvious cause of Hypertension, which can often then be cured. Till now, 99% are never diagnosed because of the difficulty and unavailability of tests. Hopefully this is about to change.”
The research involved patients from St Bartholomew’s Hospital, Cambridge University Hospital, and Guy’s and St Thomas’s. It was funded by the National Institute of Health Research and Barts Charity , with help from research fellows funded by the Medical Research Council and British Heart Foundation .