A man who struggled with high blood pressure for more than a decade, has described his incredible recovery after taking part in a study at Addenbrooke’s Hospital.
Chris Miller, aged 68 and from Friday Bridge near Wisbech, said the FABULAS study has saved him from a lifetime on medication and the possibility of getting even more unwell.
Chris, a retired mental health worker, said:
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.
When Mr Miller was referred to Addenbrooke’s, his blood pressure was 50 per cent higher than normal despite maximum doses of three kinds of medication.
He was diagnosed with primary aldosteronism, a common cause of high blood pressure, and was invited by Professor Mark Gurnell to take part in the FABULAS study.
Results from the study published today in The Lancet (7th February) show how a novel tracer molecule and a minimally invasive treatment could help millions of people with primary aldosteronism worldwide who currently go undiagnosed and untreated.
One in three adults in the UK have high blood pressure and one in twenty of these are due to primary aldosteronism caused by benign nodules in the adrenal glands. Fewer than one per cent of people with primary aldosteronism are currently diagnosed. Putting them at increased risk of heart attacks, strokes and kidney failure.
The existing diagnostic process for primary aldosteronism includes an invasive procedure that can only be performed in the UK at fewer than a dozen specialist hospitals. Treatment then involves invasive surgery with days in hospital, and weeks of recovery, or a life-long course of medication.
The approach used in the trial dramatically improves the outlook for people with primary aldosteronism by combining a novel diagnostic tracer molecule, a PET scan and a new treatment, referred to as targeted thermal therapy (Triple T).
First, the molecular tracer is injected into the blood which makes the nodules visible in PET scans. The scan takes just 10 minutes and could become available at most large hospitals, meaning many more people can be diagnosed.
Once diagnosed, some patients could then be treated using the 20-minute Triple T procedure where an endoscope in the stomach is used to guide a needle into the adrenal nodule so it can be destroyed using radio waves. At present, Triple T can only be used for nodules in the left adrenal gland, which is close enough to the stomach for the treatment to work.
When Chris had his PET scan it clearly showed a nodule in his left adrenal gland, which meant he was able to be treated using Triple T.
After the treatment, Chris recovered quickly and was discharged shortly after. His blood pressure has returned to normal, and he no longer requires medication.
Without the trial, Chris would have needed a more invasive surgery to completely remove his adrenal gland and faced weeks of recovery in hospital.
“They tell you to take it easy afterwards,” he said, “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. I’m free to enjoy long walks on the Norfolk coast with my wife Mandy and our dog Bailey.”
He added that although he also has type two diabetes, the surgery had helped to motivate him to be more active and lose weight.
Clinical Endocrinology Lead at Addenbrooke’s Hospital and Professor of Clinical Endocrinology at the University of Cambridge, Professor Mark Gurnell, said:
Chris is an outstanding example of how this approach could change the lives. It won’t always be a complete cure for everyone, but it will help bring any symptoms that do remain under control.
Professor Gurnell continued: “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.”
Professor Morris Brown, a lead on the study and co-senior author on the publication 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 10-20% 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.”
Professor Stephen Pereira, Chief Investigator of FABULAS and Professor of Hepatology & Gastroenterology at UCL Institute for Liver and Digestive Health, said:
With appropriate training, this less invasive technique could be widely offered in endoscopy units across the UK and beyond.
FABULAS included 28 people with primary aldosteronism. Following treatment many participants were able to stop all blood pressure medications, with no recurrence of the condition.
The research was primarily supported by the British Heart Foundation and National Institute for Health and Care Research (NIHR) through the Barts and Cambridge Biomedical Research Centres (BRCs).
The FABULAS trial is being followed by a larger randomised trial, called ‘WAVE’, which will compare this new treatment to traditional surgery in 120 patients. The results are expected in 2027.
Read more about this work from Queen Mary University of London (opens in a new tab).
If you would like the opportunity to take part in studies like this at CUH, you can use the MyChart app to express your interest in being contacted about studies that are relevant to you. Find out more.