Millions of people in the UK struggling with difficult-to-treat high blood pressure could soon benefit from a revolutionary 10-minute scan. This new diagnostic tool, developed by researchers at University College London (UCL), promises to accurately identify a previously hard-to-detect cause of the condition, paving the way for highly effective, targeted treatments.
The Hidden Cause of Hypertension
For approximately a quarter of individuals with high blood pressure, the root of the problem lies in their adrenal glands. These small glands, situated above the kidneys, produce an excess amount of a hormone called aldosterone, which is responsible for regulating salt levels in the body. This condition, known as primary aldosteronism, has been notoriously difficult to diagnose with conventional tests, meaning countless patients have been receiving suboptimal treatment for years.
Professor Bryan Williams, Chair of Medicine at UCL and the leader of the study, told Medicalxpress: 'We have been waiting for a test like this for many decades. This British innovation is going to transform the diagnosis of aldosterone excess as an important and previously hidden cause of hypertension in many of our patients.'
How the Pioneering Scan Works
The breakthrough involves a specialised type of imaging known as a PET-CT scan. The team at UCL engineered a novel radioactive tracer compound designed to seek out and bind to a specific enzyme, aldosterone synthase, which is responsible for producing the aldosterone hormone.
When this tracer is injected into a patient's veins, it is taken up by the parts of the adrenal gland that are over-producing aldosterone. These overactive areas then visibly 'light up' on the scan. The computed tomography (CT) component creates detailed 3D images, while the positron emission tomography (PET) part maps the precise accumulation of the tracer.
In their research, recently published in the New England Journal of Medicine, the scientists successfully scanned 17 patients. The scan identified the source of aldosterone over-production in every single patient without any side effects.
'This is the first time we have been able to visualize this disease. We can see it light up on the scan,' Professor Williams added. 'The intensity of the signal reflects the level of aldosterone over-production. This might allow us, in future, to more precisely target these over-producing areas.'
Transforming Treatment and Future Prospects
This precise visualisation is a game-changer for treatment decisions. For patients diagnosed with this condition, doctors can now confidently recommend one of two targeted approaches: either surgical removal of the overactive adrenal gland or a course of specific medicines that block the hormone's production.
This development is the culmination of over ten years of work by Professor Erik Arstad and his colleagues at UCL, who pioneered the novel method for creating radioactive tracers. Professor Arstad commented on the clinical application: 'It is very rewarding to bring laboratory innovation into the clinic for the benefit of patients with hard-to-treat hypertension.'
Following these promising initial results, the research team has now embarked on a larger phase 2 clinical trial. The goal is to gather sufficient data to seek approval for the scan to be rolled out across the NHS, potentially helping the estimated 14 million people in the UK living with high blood pressure.
High blood pressure significantly raises the risk of heart attacks, strokes, kidney disease, and premature death. The British Heart Foundation has expressed concern that many people in the UK may be living with undiagnosed hypertension. Common symptoms can include headaches, blurred vision, chest pain, and nosebleeds.
