Patient’s high blood pressure cured after trial of new treatment at Addenbrooke’s Hospital in Cambridge that could help millions worldwide

A Cambridgeshire man has told how he has been cured of high blood pressure after a decade following a new minimally invasive procedure at Addenbrooke’s that could help millions of people worldwide.

Chris Miller, 68, from Friday Bridge, near Wisbech, has struggled with high blood pressure for more than a decade.

But after taking part in a study at the Cambridge hospital, he has been spared the prospect of his condition worsening or the need to take pills for the rest of his life.

“Since taking part in the trial, I haven’t had any issues with blood pressure – I'm cured. I thought I could be battling with high blood pressure for the rest of my life. Now it’s not a problem and I’m fitter and healthier than ever,” said Chris, who was a mental health worker.

Chris’ blood pressure was 50 per cent higher than normal when he was referred to Addenbrooke’s despite being on maximum doses of three kinds of medication.

He was diagnosed with primary aldosteronism, a common cause of high blood pressure, and invited by Professor Mark Gurnell to take part in a study, called FABULAS.

Results from it were published in The Lancet on Friday (7 February) and demonstrate how a novel tracer molecule and a minimally invasive treatment could help millions of people around the world with primary aldosteronism who currently go undiagnosed and untreated.

Prof Gurnell, clinical endocrinology lead at Addenbrooke’s Hospital and professor of clinical endocrinology at the University of Cambridge, said: “Chris is an outstanding example of how this approach could change lives. It won’t always be a complete cure for everyone, but it will help bring any symptoms that do remain under control.

“Thanks to this work, we may finally be able to diagnose and treat more people with primary aldosteronism, lowering their risk of developing cardiovascular diseases and other complications, and reducing the number of people dependent on long-term blood pressure medication.”

One in three UK adults have high blood pressure and the cause of one in 20 of these cases is primary aldosteronism caused by benign nodules in the adrenal glands.

But fewer than one per cent of people with primary aldosteronism are currently diagnosed, which puts them at increased risk of heart attacks, strokes and kidney failure.

Diagnosing primary aldosteronism currently involves an invasive procedure that can only be performed at fewer than a dozen specialist hospitals in the UK, while treatment involves invasive surgery with days in hospital and weeks of recovery, or a lifelong course of medication.

The trial tested a process involving a novel diagnostic tracer molecule, a PET scan and a new treatment, referred to as targeted thermal therapy (Triple T).

The molecular tracer is injected into the blood to make the nodules visible in a PET scan. This scan takes just 10 minutes and could be made available at most large hospitals.

After diagnosed, some patients could benefit from the 20-minute Triple T procedure, in which an endoscope in the stomach is used to guide a needle into the adrenal nodule so it can be destroyed using radio waves.

Currently, Triple T can only be used for nodules in the left adrenal gland, as it is close enough to the stomach for the treatment to work.

Chris’ PET scan clearly showed a nodule in his left adrenal gland, meaning he could be treated with Triple T.

He quickly recovered and was discharged shortly after. Since then, his blood pressure has returned to normal and he no longer needs medication.

Without the trial, he would have required more invasive surgery to completely remove his adrenal gland, which would have meant weeks in hospital..

“They tell you to take it easy afterwards, but thanks to this study I was able to go back to normal quickly. I went back to work and was able to get life back to normal. It is great not having to remember to take pills all the time,” he said.

Chris has type two diabetes, but the surgery had helped to motivate him to be more active and lose weight.

“I’m free to enjoy long walks on the Norfolk coast with my wife Mandy and our dog Bailey,” he added.

Prof Morris Brown, co-senior author of the FABULAS study and professor of endocrine hypertension at Queen Mary University of London and professor of endocrinology at Barts Health NHS Trust, said: “It is 70 years since the discovery in London of the hormone aldosterone, and, a year later, of the first patient in USA with severe hypertension due to an aldosterone-producing tumour. This patient’s doctor, Jerome Conn, predicted, with perhaps only minor exaggeration, that 10 to 20 per cent of all hypertensions might one day be traced to curable nodules in one or both glands. We are now able to realise this prospect, offering 21st-century breakthroughs in diagnosis and treatment.”

Prof Stephen Pereira, chief investigator of FABULAS and professor of hepatology and gastroenterology at UCL Institute for Liver and Digestive Health, added: “With appropriate training, this less invasive technique could be widely offered in endoscopy units across the UK and beyond.”

The FABULAS trial included 28 people with primary aldosteronism and many of them were able to stop taking all blood pressure medications after taking part, with no recurrence of the condition.

A larger randomised trial, called WAVE, will now compare this treatment to traditional surgery in 120 patients, with results due in 2027.

FABULAS is an acronym for Feasibility study of radiofrequency endoscopic ABlation, with ULtrasound guidance, as a non-surgical, Adrenal Sparing treatment for aldosterone-producing adenomas.

The technical name for Triple T is endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA).