Primary aldosteronism (PA) is one the single most common causes of hypertension, but identifying patients with PA—and knowing which ones may benefit from a surgical treatment—can be quite challenging. New research out of the United Kingdom, however, suggests that PET-CT scans using a short-acting dose of metomidate can consistently identify patients with PA and determine which PA patients are the most likely to benefit from surgery. The group shared its findings in Nature Medicine.[1]
“These aldosterone-producing nodules are very small and easily overlooked on a regular CT scan,” co-senior author Morris Brown, MD, a professor at Queen Mary University of London, said in a prepared statement. “When they glow for a few minutes after our injection, they are revealed as the obvious cause of hypertension, which can often then be cured. Until now, 99% are never diagnosed because of the difficulty and unavailability of tests. Hopefully this is about to change.”
Brown et al. examined data from 128 patients who underwent these examinations. While 61% of patients were treated with surgery, the other 39% were treated with medical therapy. Overall, the PET-CT exams using metomidate were found to be as accurate as the previous method for identifying PA, an invasive catheter test. In addition, they can be combined with a simple urine analysis to determine which patients are the most likely to have a successful surgical treatment that allows them to stop taking blood pressure medications altogether.
“Around a third of adults in the U.K. have high blood pressure, increasing the risk of heart attack and stroke,” Minister of State for Health Will Quince noted in the same prepared statement. “That’s why this technological breakthrough, made possible through government-backed funding, is hugely encouraging. This revolutionary new CT scan has the ability to save lives by identifying nodules on the bladder which cause high blood pressure so they can be removed—curing the condition so people can live healthier, happier lives.”
“This study was the result of years of hard work and collaboration between centers across the U.K.,” added co-senior author William Drake, MD, a professor at Queen Mary University of London. “Much of the ‘on the ground’ energy and drive came from the talented research fellows who, in addition to doing this innovative work, gave selflessly of their time and energy during the national pandemic emergency. The future of research in this area is in very safe hands.”
Read the full Nature Medicine analysis here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.