Doctors at Queen Mary University of London – including Gonville & Caius College Emeritus Fellow Professor Morris Brown – University College London and Barts Health have led the development of a simple, minimally invasive Targeted Thermal Therapy (Triple T) that has the potential to transform medical management of a common, but commonly overlooked, cause of high blood pressure.

This breakthrough, published on Friday in the medical journal The Lancet, could, after further testing, help millions of people worldwide who currently go undiagnosed and untreated.

In the UK, Triple T, known scientifically as endoscopic ultrasound-guided radiofrequency ablation, was rigorously tested, in collaboration with researchers from University College London, University College Hospital NHS Trust, Cambridge University NHS Trust, and the University of Cambridge.

High blood pressure affects one in three adults, of whom a hormonal condition called primary aldosteronism accounts for one in 20 cases. However, fewer than one percent of those affected are ever diagnosed.

The condition occurs when tiny benign nodules in one or both adrenal glands produce excess aldosterone, a hormone that raises blood pressure by increasing salt levels in the body. Patients with primary aldosteronism often do not respond well to standard blood pressure medications and face higher risks of heart attacks, strokes, and kidney failure.

Until now, the only effective cure for primary aldosteronism has been surgical removal of the entire adrenal gland, requiring general anaesthesia, a two-to three-day hospital stay, and weeks of recovery. As a result, many patients go untreated.

Triple T offers a faster, safer alternative to surgery, by selectively destroying the small adrenal nodule without removing the gland. This is made possible by recent advances in diagnostic scans, using molecular dyes that accurately identify and locate even the smallest adrenal nodules. Those in the left adrenal gland are seen to be immediately adjacent to the stomach, from where they can be directly targeted.

Professor Brown, co-senior author of the FABULAS* study and Professor of Endocrine Hypertension at Queen Mary University of London, said: “It is 70 years since the discovery in London of the hormone aldosterone, and, a year later, of the first patient in USA with severe hypertension due to an aldosterone-producing tumour. This patient’s doctor, Jerome Conn, predicted, with perhaps only minor exaggeration, that 10-20% of all hypertensions might one day be traced to curable nodules in one or both glands. We are now able to realise this prospect, offering 21st-century breakthroughs in diagnosis and treatment.”

Read the full paper on The Lancet’s website

Read about the impact of the research on a patient at Addenbrooke’s Hospital, Cambridge

* FABULAS is an acronym for Feasibility study of radiofrequency endoscopic ABlation, with ULtrasound guidance, as a non-surgical, Adrenal Sparing treatment for aldosterone-producing adenomas.