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Doctors from Queen Mary University of London conducted a study using a new type of CT scan to detect tiny nodules in the adrenal glands and treat hypertension by removing them. Nodules are found in 1 in 20 people with high blood pressure.
The study, published in Nature Medicine, solves the problem of finding hormone-producing nodules without the complicated catheter examination available only in a few hospitals. The study also showed that when combined with a urinalysis, the scan identifies a group of patients who stop taking all hypertension medications after treatment.
For the study, 128 people were scanned after doctors discovered that their hypertension was caused by the steroid hormone aldosterone. Scans showed that in two-thirds of patients with increased aldosterone secretion, the hormone arose from a benign nodule in one of the adrenal glands that could be safely removed.
The scan uses a short-acting dose of methomidate, a radioactive dye that only sticks to the aldosterone-producing node. The scan was as accurate as the old catheter test, yet fast, painless, and successful for every patient. Combination of “hot node” and urinalysis for steroids found 18 out of 24 patients whose blood pressure returned to normal after taking all drugs.
Morris Brown, Professor of Endocrine Hypertension at Queen Mary University of London, explains: “These aldosterone-producing nodules , are very small and easily overlooked on conventional CT scans. Until now, 99% of cases are not diagnosed due to the complexity and unavailability of tests. I hope this changes soon”.
A previous study by a team at Queen Mary University found that 5-10% of people with hypertension are caused by a gene mutation in the adrenal gland that results in overproduction of the steroid hormone aldosterone. Aldosterone causes salt to stay in the body, raising blood pressure. Patients with excessive levels of aldosterone in the blood are resistant to treatment with commonly used drugs for hypertension and have an increased risk of heart attacks and strokes.
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