A new 10-minute diagnostic scan, developed by researchers at University College London (UCL), offers a revolutionary approach to treating difficult-to-treat high blood pressure. This innovation is particularly significant for millions of individuals whose hypertension stems from a specific, often undiagnosed, underlying cause.

Approximately one-quarter of people living with high blood pressure suffer from a condition where their adrenal glands produce an excessive amount of aldosterone. Aldosterone is a crucial hormone responsible for regulating salt levels in the body. Historically, this problem has been notoriously difficult to diagnose, leading many patients to remain unaware of its true origin. The previous invisibility of this adrenal overactivity to other diagnostic tests meant that affected individuals often 'flew under the radar' regarding targeted treatment.

The groundbreaking PET-CT scan, whose findings were recently described in a research letter published in the New England Journal of Medicine, is capable of revealing this previously hidden adrenal overactivity. Crucially, it not only confirms the presence of excessive aldosterone production but also precisely pinpoints the exact locations within the adrenal glands where this overactivity is occurring. This unprecedented clarity makes it significantly easier for medical professionals to determine the most effective treatment approach for patients, which could involve surgically removing an over-producing adrenal gland or administering medications that block aldosterone production.

Professor Bryan Williams, Chair of Medicine at UCL and the leader of this pivotal study, expressed profound satisfaction with the development. He told Medicalxpress, 'We have been waiting for a test like this for many decades.' He further emphasized that 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,' offering 'huge potential to completely change the way we make this diagnosis and enable us to provide better targeted treatment for our patients.'

The scan's efficacy relies on a specialized PET-CT system. The computed tomography (CT) component generates detailed 3D images of the internal body, while the positron emission tomography (PET) element maps the accumulation of a tiny amount of a radioactive tracer. The UCL team engineered a novel tracer compound designed to specifically bind to aldosterone synthase, the enzyme responsible for producing aldosterone. When this tracer is taken up by the parts of the adrenal gland that are over-producing the hormone, these areas illuminate on the scan, making the source of the excess hormone production clearly visible.

In the initial paper, the scientists detailed how they successfully scanned 17 patients, identifying the source of over-production in every participant without any reported side effects. Professor Williams highlighted this as a significant milestone, stating, 'This is the first time we have been able to visualize this disease. We can see it light up on the scan.' He added that '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.'

This pioneering achievement is the culmination of over a decade of dedicated work by Professor Erik Arstad and his colleagues at the same university, who developed an innovative method for creating radioactive tracers. It was through their advanced techniques that the specific tracer for aldosterone synthase could be successfully created. Professor Arstad reflected on the breakthrough, stating, '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 is now conducting a phase 2 clinical trial, aiming to gather sufficient data for potential approval and implementation within the NHS. This could significantly impact the management of high blood pressure across the UK.

High blood pressure is a widespread health concern, affecting an estimated 14 million people in the UK. It is a major risk factor for serious conditions such as heart attack, stroke, kidney disease, and premature death. Worryingly, the British Heart Foundation indicates that many individuals in the UK may be living with undiagnosed high blood pressure. Common symptoms, according to the NHS, can include headaches, blurred vision, chest pain, and nosebleeds. While the likelihood of developing high blood pressure increases with age, several other risk factors contribute to its development, including a family history of the condition, ethnicity, an unhealthy diet, being overweight, smoking, excessive alcohol consumption, and stress. Individuals who suspect they have high blood pressure are strongly advised to get it checked at a pharmacy or their local GP surgery, with many pharmacies offering free blood pressure checks for people aged 40 or older.