Researchers have developed a groundbreaking, minimally invasive treatment that could offer hope for millions of people with a form of high blood pressure caused by a commonly overlooked condition.
The treatment, called Triple T, addresses primary aldosteronism (PA) – a hormonal disorder that causes high blood pressure in one in 20 patients with blood pressure yet is often undiagnosed and untreated.
Triple T was developed by a team from UCL, UCLH, Queen Mary University of London and Barts Health NHS Trust, and results from a feasibility trial of the treatment are published this month in The Lancet. The trial, called FABULAs, showed the treatment is safe and effective, with many participants able to stop all blood pressure medications, and the condition did not recur in them.
In PA, benign nodules in the adrenal glands produce excess aldosterone, a hormone that raises blood pressure by increasing salt levels in the body.
Until now, the only effective treatment for PA has been the surgical removal of the affected adrenal gland. However, this procedure requires general anaesthesia, a hospital stay, and weeks of recovery, causing many patients to go untreated. Triple T provides a faster, safer, and less invasive alternative by targeting and destroying the malfunctioning adrenal nodule without removing the gland.
For the procedure, a fine needle is inserted through the stomach to the adrenal gland, guided by real-time ultrasound imaging, where short bursts of heat are used to destroy the problematic tissue. This targeted approach ensures minimal damage to surrounding healthy tissues. The entire procedure lasts only 20 minutes and requires no incision.
28 patients with PA received Triple T treatment in the FABULAs trial. Most experienced normalised hormone levels within six months.
The research team said it could become an accessible alternative to surgery, offering relief to those with PA, with BRC-supported Professor Stephen Pereira, Chief Investigator of FABULAS, saying: “This less invasive technique could be widely offered in endoscopy units across the UK and internationally.”
The success of the FABULAs trial has led to a larger study, WAVE, which will compare Triple T with traditional surgery in 120 patients. Results are expected in 2027.
The research was primarily supported by Barts Charity, the NIHR and the British Heart Foundation.
Image credit: Adobe Stock / grinny
