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New Scan Could Improve Treatment for Hard-to-Treat High Blood Pressure

Hypertension remains one of the most common health problems worldwide, and for many patients, it is challenging to control despite treatment. A recent imaging advance could help doctors more quickly identify an often-overlooked hormonal cause and choose the right treatment.

A new type of scan, just ten minutes long, could improve treatment for millions of people with high blood pressure, according to a study coordinated by researchers from University College London (UCL) and published, on Wednesday, in New England Journal of Medicine – NEJM.

Understanding Aldosterone and Hypertension

About a quarter of patients with high blood pressure may have adrenal glands that produce too much aldosterone,a hormone that regulates salt and potassium levels in the body. This condition, known as primary aldosteronism, often goes undiagnosed because customary tests aren’t always accurate. High aldosterone levels lead to increased sodium retention and potassium excretion, raising blood pressure and increasing the risk of heart attack, stroke, and kidney disease.

The Challenge of Diagnosis

Currently, diagnosing primary aldosteronism involves a complex process, including blood tests to measure aldosterone and renin (an enzyme produced by the kidneys) levels, followed by more detailed imaging scans like CT or MRI.These scans aren’t always effective at pinpointing the source of excess aldosterone production, especially in cases of bilateral adrenal hyperplasia (where both adrenal glands are affected). The current diagnostic pathway can take months, delaying appropriate treatment.

How the New Scan Works

The new scan utilizes a radioactive tracer called ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) combined with PET (Positron Emission Tomography) imaging. PET scans detect areas of high metabolic activity. Adrenal tissue producing excess aldosterone exhibits increased glucose uptake, making it visible on the scan. Unlike traditional CT or MRI scans, this PET scan can differentiate between benign and malignant adrenal tumors and accurately identify the source of aldosterone overproduction, even in cases of bilateral adrenal hyperplasia.

The study found that the scan correctly identified the source of excess aldosterone in 93% of patients. This improved accuracy allows doctors to determine whether to treat patients with mineralocorticoid receptor antagonists (drugs that block the effects of aldosterone) or, in some cases, consider adrenal surgery.

Key Takeaways

• The new PET scan considerably improves the diagnosis of primary aldosteronism, a common but often overlooked cause of hypertension.
• The scan is quick (10 minutes) and accurate, identifying the source of excess aldosterone in 93% of patients.
• Accurate diagnosis leads to more targeted treatment, perhaps reducing the risk of cardiovascular events and kidney disease.
• This advancement could benefit millions of people struggling to control their high blood pressure.

The progress of this new scan represents a important step forward in the management of hypertension. As the technology becomes more widely available, it promises to improve the lives of countless individuals living with this challenging condition. Further research will focus on optimizing the scan protocol and assessing its long-term impact on patient outcomes.

Publication Date: 2025/11/29 05:59: