Cause and cure discovered for common type of high blood pressure
Researchers have found that the cause of a common type of high blood pressure originates in a tiny benign nodule, present in one-in-twenty people with hypertension. The nodule produces a hormone, aldosterone, that controls how much salt is in the body. The new discovery is a gene variant in some of these nodules which leads to a vast but intermittent overproduction of the hormone.
Writing in Nature Genetics, researchers describe that the newly-discovered gene variant causes several problems, which makes it hard for doctors to diagnose some patients with hypertension. Firstly, the variant affects a protein called CADM1 and stops cells in the body from "talking" to each other and saying that it is time to stop making aldosterone.
Also an issue for doctors is the fluctuating release of aldosterone throughout the day, which at its peak causes salt overload and hypertension. This fluctuation explains why patients with the gene variant can elude diagnosis unless they happen to have blood tests at different times of day.
The researchers also discovered that this form of hypertension could be cured by unilateral adrenalectomy—removing one of the two adrenal glands. Following removal, previously severe hypertension despite treatment with multiple drugs disappeared, with no treatment required through many subsequent years of observation.
Fewer than 1% of people with hypertension caused by aldosterone are identified because aldosterone is not routinely measured as a possible cause. The researchers are recommending that aldosterone be measured through a 24-hour urine test rather than one-time blood measurements, which will reveal more people living with hypertension but going undiagnosed.
Incredible if true. I'd volunteer for testing and treatment. I might even want to get the surgery. I've had chronically high BP for years, and even with the meds piled on, even with tons of staircase training and distance walking, my BP has almost never been in the classic normal range (120/80). Oh, I've been there once or twice, but the BP never stays there. Thus, the intuition has formed that there's something fairly basic that's wrong with me. Mind you, I'm not seizing on this new thing as the answer to my conundrum; I'm simply suggesting this might be a promising avenue of research for me personally, as someone with stubbornly high BP. And a simple urine test could be revealing!
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