In about 5% to 10% of high blood pressure cases, the source is a gene mutation in the adrenal glands, according to earlier research. Tiny benign nodules in the glands lead to excessive production of the steroid hormone aldosterone, which causes salt to be retained in the body and drives up blood pressure.
Unfortunately, folks with this type of high blood pressure don’t usually respond to common blood pressure medications.
With a new type of CT scan, researchers say they can light up the nodules. Creation of this simpler screening test could lead to surgical removal of the nodule, curing the high blood pressure (also called hypertension) in this specific group of patients.
“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,” said Morris Brown, co-author of the study and professor of endocrine hypertension at Queen Mary University of London.
“Until now, 99% are never diagnosed because of the difficulty and unavailability of tests. Hopefully, this is about to change,” Brown said in a university news release.
In most cases of high blood pressure, the cause is unknown. It typically requires lifelong treatment with medications.
Prior to this development, the method for detecting these hormone-producing nodules was a difficult catheter study that wasn’t widely available and didn’t always work.
Researchers studied this new, 10-minute scan in 128 people whose high blood pressure was caused by aldosterone.
In two-thirds of the patients who had elevated aldosterone secretion, this was coming from nodules on the adrenal glands. Surgical removal of the nodules brought blood pressure down.
The scan uses a very short-acting dose of metomidate, a radioactive dye that sticks only to the aldosterone-producing nodule. It was as accurate as the old catheter test, but quick, painless and successful in every patient, the study noted.
The findings were published Jan. 16 in Nature Medicine.
The U.S. Centers for Disease Control and Prevention has more on hypertension.
SOURCE: Queen Mary University of London, news release, Jan. 6, 2023
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