A new non-invasive treatment for a form of high blood pressure is on the horizon. (New Africa/Shutterstock)

LONDON — High blood pressure affects one in three adults worldwide, but for some patients, the real culprit is a small tumor in their adrenal glands that conventional medications can’t fix. To treat this, surgeons have been removing entire adrenal glands for decades. Now, UK researchers have developed a 20-minute procedure that achieves the same goal through the stomach without a single external cut. This breakthrough could transform treatment for millions of patients worldwide who struggle with medication-resistant hypertension.

The form of high blood pressure this treatment targets is called primary aldosteronism. It affects up to 13% of all people with high blood pressure, making it a surprisingly common but underdiagnosed condition. According to research published in The Lancet, one of the world’s leading medical journals, it occurs when small benign tumors in the adrenal glands produce too much of a hormone called aldosterone, which raises blood pressure by increasing salt levels in the body. These patients face twice the risk of heart attacks, strokes, and kidney failure compared to people with regular high blood pressure, and often don’t respond well to standard blood pressure medications.

Despite its prevalence, fewer than 1% of cases are currently diagnosed. Many patients spend years taking multiple blood pressure medications with limited success, unaware that a small, treatable tumor is the root cause of their problem. The traditional solution, surgical removal of the entire adrenal gland, requires general anesthesia, several days in the hospital, and weeks of recovery time. This invasive approach has discouraged many patients and doctors from pursuing treatment.

The new technique, dubbed “Triple T” (Targeted Thermal Therapy), represents a major advancement in treating this condition. The process is scientifically known as EUS-RFA (Endoscopic Ultrasound-Guided Radiofrequency Ablation). Instead of removing the entire adrenal gland through traditional surgery, doctors use an endoscope, a flexible tube with a camera, inserted through the mouth and into the stomach to reach the problematic tumor. From there, they can destroy just the tumor while leaving the rest of the healthy gland intact.

“This breakthrough was made possible thanks to the collaborative development of novel PET tracer molecules, which enable non-invasive diagnosis by allowing us to precisely locate and treat adrenal nodules for the first time,” says professor Mark Gurnell from the University of Cambridge, in a statement.

Between 2018 and 2023, researchers tested this new approach on 28 patients across three UK hospitals. The study participants, who averaged 57 years old, included 21 men and 7 women, with a diverse ethnic makeup of 57% White, 39% Black, and 4% Asian patients. Each person had previously been diagnosed with primary aldosteronism and had a tumor on their left adrenal gland that was causing their condition.

The procedure itself takes about 20 minutes and uses two well-established medical techniques in a novel way. First, ultrasound creates a real-time video of the area, allowing doctors to guide their instruments precisely. Then, radiofrequency waves generate heat in a tiny needle placed into the tumor, creating a controlled burn that destroys the problematic tissue while sparing surrounding healthy areas.

Most procedures were performed under general anesthesia, though one hospital successfully used deep sedation instead. Seven patients needed a second procedure when follow-up imaging showed their tumors weren’t completely destroyed on the first attempt. Despite these repeat procedures, the safety record was impressive – across all 35 treatments, there were no major complications like bleeding, organ damage, or serious infections.

The results showed real promise: 75% of patients saw significant improvement in their hormone levels, and 43% experienced meaningful improvements in their blood pressure. Most remarkably, four patients were completely cured of their high blood pressure and no longer needed any medications. On average, patients were able to reduce their blood pressure medication use by about 1.4 doses per day.

“Before the study, I suffered from debilitating headaches for years despite multiple GP visits. As a full-time worker and single parent, my daily life was severely affected. This non-invasive treatment provided an immediate recovery—I was back to my normal routine straight away. I’m incredibly grateful to the team for giving me this choice,” says trial participant Michelina Alfieri.

Currently, only left-sided adrenal tumors can be treated this way because the left adrenal gland sits very close to the stomach wall, making it accessible through an endoscope. Right-sided tumors would require a different approach, which researchers are currently studying in a larger trial called WAVE. The WAVE trial, which will include 120 patients, compares this new technique to traditional surgery for both left and right-sided tumors. Results are expected in 2027.

“With appropriate training, this less invasive technique could be widely offered in endoscopy units across the UK and internationally,” says professor Stephen Pereira from University College London.

This research demonstrates how modern medicine can transform major surgery into a minimally invasive procedure, potentially making treatment accessible to millions more patients worldwide. For the vast number of people suffering from undiagnosed primary aldosteronism, this advancement offers new hope for effective treatment without the barriers of major surgery.