10-minute test helps detect ‘curable’ hypertension

If you’re diagnosed with high blood pressure you know the drill…

Your doctor tells you to exercise, lower your salt intake, lose weight and stop smoking if you’re a smoker.

Also, your doctor most likely prescribes medication designed to reduce blood pressure.

But what if those steps aren’t enough to get your blood pressure under control?

In that case, you have what’s known as resistant hypertension. And your doctor may be overlooking the most common cause of secondary hypertension…

Blood pressure and your adrenal gland

The majority of high blood pressure cases are classified as primary or essential hypertension, meaning they don’t have an underlying cause. There are only two ways of treating primary hypertension: lifestyle modification or medication (or sometimes both).

Then there’s secondary hypertension, which means the individual’s high blood pressure has an identifiable cause, most likely triggered by existing health issues like kidney disease, obstructive sleep apnea and Cushing’s syndrome.

However, the most common cause of secondary hypertension has to do with a part of the body, you hear little about… your adrenal glands.

Your adrenal glands sit right next to your kidneys and produce adrenaline, cortisol and sex hormones.

They also produce the hormone aldosterone — the overproduction of which affects the body’s balance of salt and water.

And if you haven’t guessed, this excessive production is often caused by a tumor. Adrenal tumors are responsible for 15 percent of all hypertension cases in the U.S. — or about 10 million people.

Removal of the adrenal tumor usually normalizes the individual’s blood pressure. Unfortunately, only a fraction of patients are correctly diagnosed and treated for these tumors, but that’s changing…

The problem with diagnosing adrenal tumors

For years, the presence of an adrenal tumor or adenoma was detected in one of two ways — both problematic…

One involves using catheterization to get a sampling of the blood leaving the adrenal gland.

In the second, noninvasive method, radiologists used an iodine agent to measure cholesterol uptake, which is a precursor to aldosterone. This test required patients to take steroids for weeks before imaging and exposed them to high amounts of radiation.

The iodine agent used in the test was created by the University of Michigan in the 1970s. However, federal regulations caused it to be discontinued in the late 2000s.

In 2022, a University of Michigan team developed a new agent that replaces iodine with fluorine-18, a radioisotope commonly used in PET scans. The researchers found that this method could allow screening for hypertension-linked adrenal tumors with significantly less radiation exposure and limited steroid use.

But thanks to doctors at Queen Mary University of London and Barts Hospital, and Cambridge University Hospital a new technique can determine if an adrenal tumor is raising your blood pressure in just 10 minutes…

Published in Nature Medicine, the doctors led research using a new type of CT scan to light up tiny nodules in the adrenal gland and cure high blood pressure by their removal.

The nodules are discovered in one-in-twenty people with high blood pressure. The research also found that, when combined with a urine test, the scan detects a group of patients who come off all their blood pressure medicines after treatment.

When to test for a hypertension-causing adrenal tumor

According to Professor Morris Brown, co-senior author of the study and Professor of Endocrine Hypertension at Queen Mary University of London, “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. Until now, 99% are never diagnosed because of the difficulty and unavailability of tests. Hopefully, this is about to change.”

If you’re suffering from resistant hypertension and your doctor hasn’t tested you for an adrenal tumor, it’s a good idea to broach the subject. But that’s not the only circumstance in which you should be tested.

If you fall into any of the following categories, you should have your doctor request an adrenal tumor diagnostic:

• Your hypertension requires two or more blood pressure medications to manage.
• You’re taking spironolactone (Aldactone), eplerenone (Inspra) or amiloride for hypertension.
• You have hypertension despite having none of the known risk factors (i.e., age, smoking, diabetes, obesity, kidney problems, etc.).
• You’re younger than 50 and have hypertension.
• Your hypertension is accompanied by hypokaleia, or low blood potassium.
• You have both hypertension and sleep apnea.
• You have hypertension and a family history of early-onset (younger than 50) hypertension or stroke at a young age.
• You have hypertension and one or more of your family members has had an adrenal tumor.
• Your hypertension is episodic, meaning it comes and goes.

Sources:

Researchers develop new agent to help root out hypertension-causing tumor — Michigan Health Lab

Development of Fluorinated NP-59: A Revival of Cholesterol Utilization Imaging with PET — Journal of Nuclear Medicine

Ten-minute scan enables detection and cure of the commonest cause of high blood pressure — Science Daily

Adrenal Tumors Causing High Blood Pressure (Hypertension) — Carling Adrenal Center

Endocrine Related Hypertension — Endocrine Society

Tired, depressed and hurting? It could be adrenal fatigue — Easy Health Options