A pioneering medical treatment has the potential to transform the management of high blood pressure caused by a largely underdiagnosed condition, primary aldosteronism. Developed by doctors at Queen Mary University of London, Barts Health NHS Trust, and University College London, the simple, minimally invasive procedure, known as Targeted Thermal Therapy (Triple T), could soon offer an alternative to the invasive surgery currently required for many patients.
Published in The Lancet, this breakthrough offers hope for millions of people worldwide who remain undiagnosed and untreated for the condition. Primary aldosteronism, a hormonal disorder, affects approximately one in twenty individuals with high blood pressure, though less than one percent of cases are diagnosed. It occurs when benign nodules in the adrenal glands produce excess aldosterone, which raises blood pressure by increasing salt levels in the body. Left untreated, it leads to severe health complications such as heart attacks, strokes, and kidney failure.
Traditionally, the only cure for primary aldosteronism has been the surgical removal of the adrenal gland. However, the procedure requires general anesthesia, a lengthy hospital stay, and weeks of recovery, leading many patients to go untreated. Triple T, however, promises a quicker, safer alternative by selectively targeting and destroying the nodule without removing the gland. This procedure uses recent advances in diagnostic scans and ultrasound guidance to pinpoint even the smallest nodules, making it a highly effective treatment option.
The technique combines radiofrequency or microwave energy with ultrasound to create heat within a needle, which is then inserted into the affected tissue. The heat destroys the abnormal tissue without harming surrounding areas, and the procedure takes just 20 minutes with no need for incisions.
The procedure was tested in the FABULAS study, which involved 28 patients diagnosed with primary aldosteronism. The results were promising, with most patients seeing their hormone levels return to normal after six months, and many were able to stop taking blood pressure medications. The success of this study has led to the launch of a larger, randomized trial called WAVE, which will compare Triple T with traditional surgery. The results of this trial are expected by 2027.
Professor Morris Brown, co-senior author of the FABULAS study, emphasized the significance of this development, stating, “This is a 21st-century breakthrough in both diagnosis and treatment, offering a way to address high blood pressure caused by adrenal gland abnormalities.”
One patient, Michelina Alfieri, shared her positive experience with the treatment. After years of suffering from debilitating headaches, Alfieri found immediate relief after undergoing the procedure and quickly returned to her normal routine.
The research, funded by Barts Charity, the National Institute for Health and Care Research (NIHR), and the British Heart Foundation, marks a major step forward in the fight against hypertension and may soon offer a standard procedure for patients worldwide. With further research underway, Triple T could replace the need for major surgery, providing faster recovery times and better outcomes for millions of patients suffering from high blood pressure caused by primary aldosteronism.
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