Cause and cure discovered for common type of high blood pressure (Gene variant causes blood pressure spikes via adrenal gland nodule)

Medical Xpress / Queen Mary, University of London / Nature Genetics ^ | June 8, 2023 | Wu, X. et al

[ConservativeMind]

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.

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.

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 removing one of the two adrenal glands. Following removal, previously severe hypertension disappeared.

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 aldosterone be measured through a 24-hour urine test rather than one-time blood measurements.

In most people with hypertension, the cause is unknown. Previous research had discovered that in 5-10% of people with hypertension the cause is a gene mutation which results in excessive amounts of aldosterone being produced.

Aldosterone causes salt to be retained in the body, driving up the blood pressure. Patients with excessive aldosterone levels in the blood are resistant to treatment with commonly used drugs for hypertension.

"Because the aldosterone nodules in this study were so small, we are investigating whether momentary cauterization of the nodule is an alternative to surgical removal of the whole adrenal gland."

[ConservativeMind]

If you have an unexplained or unknown cause of high blood pressure, it could be worthwhile to get a 24-hour aldosterone urine test done. If positive, it might be possible to have a slight cauterization to a part of the adrenal gland done, instead of removal one of your two adrenal glands.

[ConservativeMind]

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[BipolarBob]

So, the question remains if I were to have an adrenal gland removed can I sell it for a transplant?

[Wuli]

That is one item that would help explain why hypertension runs in families so often (2 to 3 times on average more often than in folks whose families do not have a history of hypertension).

[OrioleFan]

Some of the drugs they give you for blood pressure cause you to pee a lot (ex. HCL) so the 24hr urine test would be easy.