One of the most prevalent cardiovascular illnesses is arterial hypertension, which affects older individuals more than younger people. The Global Impact of Disease study identified hypertension as a significant contributor to life years adjusted for disability globally; in addition, it impacts 1.13 billion people worldwide (20% female and 24% male), is one of the most common causes of disability, and death globally, and results in 9.4 million deaths annually, according to the Study published in International Journal of Molecular Sciences.
According to estimates from the WHO, 17.9 million deaths worldwide in 2019 were attributable to cardiovascular diseases (CVDs). The prevalence of CVDs is still high even if the mortality rate has decreased. It is crucial to mention that among the numerous causes and indicators of risk for CVDs, hypertension is one of the most readily avoidable and manageable diseases. Additionally, it is one of the important comorbidities that contribute to the development of stroke, myocardial infarction, heart failure, and renal failure, resulting in early reliance and impairment, lowering patient life expectancy, and raising healthcare costs.
But A successful treatment for a prevalent type of hypertension (high blood pressure) has been discovered by doctors at Queen Mary University of London and Barts Hospital, according to a new study published in Nature Genetics. One out of every twenty persons with hypertension has a small benign nodule as the root cause. Aldosterone, a hormone that the nodule generates, regulates the body’s salt levels. The new finding is a gene mutation found in some of these nodules that causes a significant, sporadic overproduction of the hormone.
Eurek Alert also reported that the recently identified gene mutation results in several issues, making it challenging for clinicians to diagnose some individuals with hypertension correctly. First, the variation interferes with the ability of cells in the body to communicate with one another and signal when to cease producing aldosterone by affecting a protein called CADM1. Doctors also have a problem with aldosterone’s erratic secretion throughout the day, which at its peak, contributes to hypertension and salt excess. Because of this variability, patients with the gene variation may go undiagnosed unless they obtain blood tests at different times of the day.
Additionally, the researchers found that unilateral adrenalectomy, or removing just one of both adrenal glands, helped treat this particular form of hypertension. After removal, severe hypertension that several different medications had managed vanished, and following many years of surveillance, no further therapy was needed. Aldosterone is not frequently measured as a potential cause of hypertension; hence less than 1% of those with the condition are known to have it. Instead of one-time blood measures, the researchers advise measuring aldosterone over 24 hours to identify more people who are living with hypertension but are misdiagnosed.
The first participant in the Study was identified when medical professionals discovered changes in his hormone levels while he was taking part in a clinical trial of medications for severe hypertension. Most individuals with hypertension have no idea what caused it, and medication is needed to treat them for the rest of their lives. A mutation in a gene in the glands that produce adrenaline causes excessive levels of aldosterone to be produced, which is the cause of hypertension in 5–10% of cases, according to earlier studies by the Queen Mary group. Aldosterone makes the body retain salt, which raises blood pressure.
Patients with elevated blood levels of aldosterone are more vulnerable to strokes and heart attacks and are resistant to therapy with routinely prescribed medications for high blood pressure. Professor Morris Brown, an endocrine hypertension expert at Queen Mary University of London and a co-senior author of the paper, said: ”
“This narrative highlights the positive effects of the virtuous cycle of medicine and science on the 900th birthday of Barts Hospital. The majority of patients agree that we should perform non-routine molecular analyses on surgical samples, which allows us to understand how their hypertension developed and how to treat it in future patients. We are currently examining if brief cauterization of the nodule offers an alternative to surgically removing the entire adrenal gland since the aldosterone nodules in the current Study were so small.
The research at the Queen’s Hospital was carried out by research fellows supported by grants from the British Cardiovascular Foundation, the National Institute of Health Research, the Medical Research Council, and the Royal Society. Barts Charity financed it. The researchers worked with labs in Munich, Paris, and Michigan to locate more people with the new variety. They also partnered with labs in Osak Asayama, Japan, KL, Malaysia, and Pittsburgh, USA, to further study how it affects the body.
