New scan helps detect a cause of high blood pressure

A 10-minute scan can enable the detection and cure of a common cause of high blood pressure, finds new research.

Doctors were able to detect a common cause of the condition using a new type of medical imaging scan, in research funded by an NIHR and Medical Research Council (MRC) partnership.

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The new form of CT scan lights up tiny nodules – growths of abnormal tissue – in a hormone gland. Doctors were then able to cure high blood pressure by removing these nodules. The nodules are discovered in one-in-twenty people with high blood pressure.

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The research, published in the Nature Medicine journal, solves a 60-year problem of how to detect the hormone producing nodules without a difficult catheter study that is available in only a handful of hospitals, and often fails. The research also found that, when combined with a urine test, the scan detects a group of patients who come off all their blood pressure medicines after treatment.

The study was led by researchers at Queen Mary University of London and Barts Hospital, and Cambridge University Hospital.

128 people participated in the study, after doctors found that their hypertension (high blood pressure) was because of the steroid hormone, aldosterone. It causes salt to be retained in the body, driving up blood pressure.

The scan found that in two thirds of patients with elevated aldosterone secretion, this is coming from a benign (harmless) nodule in just one of the adrenal glands, which can then be safely removed.

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The scan uses a very short-acting dose of radioactive dye that sticks only to the aldosterone-producing nodule. It was found to be as accurate as a catheter test, but quick, painless and technically successful in every patient. Until now, the catheter test was unable to predict which patients would be completely cured of hypertension by surgical removal of the gland. By contrast, the combination of a scan and urine steroid test detected 18 of the 24 patients who achieved a normal blood pressure off all their medication.

The research was conducted on patients at Barts Hospital, Cambridge University Hospital, and Guy’s and St Thomas’s, and Universities of Glasgow and Birmingham.

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. Until now, 99% are never diagnosed because of the difficulty and unavailability of tests. Hopefully this is about to change.”

Minister of State for Health Will Quince said: “Around a third of adults in the UK have high blood pressure, increasing the risk of heart attack and stroke. That’s why this technological breakthrough, made possible through government-backed funding, is hugely encouraging.

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