UCL Scientists Uncover Innovative Treatment for a Leading Cause of Elevated Blood Pressure
A revolutionary minimally invasive therapy has been developed to treat a prevalent cause of high blood pressure by researchers at UCL, Queen Mary University of London, and Barts Health. Approximately one in three adults in the UK suffers from high blood pressure, with estimates suggesting that around one in twenty cases are due to primary aldosteronism—a hormonal condition triggered by tiny benign nodules on one or both adrenal glands that produce excess aldosterone, a hormone responsible for raising blood pressure through increased salt levels.
Primary aldosteronism often proves resistant to standard medications and can lead to higher risks of heart attack, stroke, and kidney failure. However, only a small percentage of affected individuals are diagnosed. The FABULAS study published in The Lancet details the initial findings for Targeted Thermal Therapy (Triple T), tested on 28 patients with primary aldosteronism whose condition was detected using molecular scans.
Triple T represents a safer and faster alternative to surgery by selectively destroying hormone-producing nodules without removing the adrenal gland. This approach is made possible thanks to recent advancements in diagnostic technology, including the use of molecular dyes that can identify even the smallest nodules with precision. The treatment combines two established medical techniques: microwaves generate heat within a small needle placed into abnormal tissue for controlled burning, while ultrasound provides real-time imaging.
In Triple T, similar to routine endoscopy, an internal camera using both ultrasound and light is passed through the mouth into the stomach. An endoscopist then visualizes the adrenal gland and guides a fine needle from the stomach precisely into each identified nodule. Short bursts of heat are applied to destroy these nodules while sparing surrounding healthy tissue. The entire procedure takes just 20 minutes, eliminating internal or external incisions.
Initial results indicate that Triple T is safe and effective, with most patients achieving normal hormone levels six months post-treatment. Many participants were able to discontinue blood pressure medications without the condition recurring. This innovative approach now enters a larger randomized trial called ‘WAVE’, which will compare it against traditional adrenal surgery in 120 patients, with results expected by 2027.
“We are delighted that our pioneering research is leading towards transforming diagnosis and treatment of this common form of hypertension,” said Professor Morris Brown, co-senior author of the FABULAS study. “The prospect offered by Triple T reflects the medical progress achieved in understanding and treating hormonal disorders over recent decades.”
Current methods for curing primary aldosteronism involve surgical removal of entire adrenal glands, a process requiring general anesthesia, hospital stays ranging from two to three days, and extended recovery periods. This often results in many patients opting out of treatment due to these complications.
The adrenal glands play critical roles in controlling blood pressure and metabolism among other functions by producing hormones such as cortisol, adrenaline, and noradrenaline. The positive outcomes of the FABULAS study have paved the way for further clinical trials that may lead to widespread adoption if confirmed by ‘WAVE’.
“If these promising initial results are validated,” said Professor Stephen Pereira from UCL’s Institute for Liver and Digestive Health, “Triple T could become a standard treatment option across endoscopy units globally. The potential of safely targeted thermal therapy delivered orally to replace major surgery is truly groundbreaking.”
