20-minute “hot ZAP” treatment can release millions of hypertensive drugs

A 20-minute procedure to destroy problematic adrenal nodules with targeted thermal therapy can provide freedom for millions of blood pressure worldwide. Minimally invasive treatments developed by UK researchers provide an attractive alternative to hormonal diseases that are generally overlooked.

The new method, tested in three major UK hospitals, uses a small needle guided by ultrasound to accurately target and destroy small hormone nodules that produce severe hypertension. The procedure does not require an incision, allowing patients to return to their homes on the same day – in stark contrast to the current treatment that requires complete surgical removal of the adrenal glands.

In the findings published by Lancet, the researchers demonstrated the safety and effectiveness of the procedure in 28 patients. Six months later, most participants showed normal hormone levels and some were able to stop their blood pressure medication altogether.

“It’s been 70 years,” said Professor Morris Brown, professor of endocrine hypertension at Queen Mary University in London. He noted that this advancement eventually realized the high level of treatment,” he said. The long-standing prediction of blood pressure, adding that they now “provides a 21st century breakthrough in diagnosis and treatment.”

This disease is called primary aldosterone and is about one in twentieth of patients with hypertension. When small benign nodules in the adrenal glands produce excess aldosterone, it is a hormone that raises blood pressure by increasing the body’s salt levels. Despite the high prevalence, less than 1% of the cases diagnosed are currently being diagnosed.

For trial participant Michelina Alfieri, treatment immediately relieves long-term symptoms. “Before the research, despite many visits, I suffered from debilitating headaches for years. As a full-time worker and a single parent, my daily life has been severely affected,” she said. “This non-invasive treatment can be restored immediately – I immediately returned to my routine.”

New technology, formally known as endoscopic ultrasound-guided radiofrequency ablation, works by passing tiny cameras through the mouth and into the stomach. Then, using ultrasound imaging, the doctor can accurately guide the needle to the problematic nodule and provide the heat of the short burst, which destroys it while keeping the surrounding healthy tissue free from harm.

Professor Stephen Pereira, research and professor of hepatology and gastroenterology at the UCL Institute of Hepatology and Gastroenterology, highlighted the potential widespread use of the program: “With proper training, this less invasive technique can be found across the UK across the country. Sugo mirror units are widely available internationally.”

Success has prompted a larger trial called “Wave” that will compare the new approach to traditional surgery in 120 patients. The results are expected to be in 2027.

“Thanks to this work, we can ultimately diagnose and treat more people with major aldosterone, reduce their risk of cardiovascular disease and other complications, and reduce the number of people relying on long-term blood pressure medications.” Clinical endocrine at Addenbrooke Hospital Mark Gurnell, the head of the school, is a professor of clinical endocrinology at the University of Cambridge.

The study was supported by BARTS charity, the National Institute of Health and Nursing through BARTS and the Cambridge Biomedical Research Centre, and the UK Heart Foundation. Advances may represent a significant shift in treating this form of hypertension, which provides hope for millions of hopes that are currently undiagnosed and untreated.