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New procedure for detecting a curable form of hypertension

mage credit: straitstimes.com/ SPH

There is a new procedure for identifying if a patient has a primary aldosteronism, a curable form of hypertension.

Using the 11C-Metomidate PET/CT scan, it is a non-invasive method which could potentially provide more accurate results.

PET is the positron emission tomography imaging test which uses radioactive tracers that are held in a special dye.

CT refers to the X-ray computed tomography scanner which creates a series of images of the body.

The scan is used to detect small growths in a patient’s glands and determine if excessive hormone aldosterone is produced from them. Excessive production of hormone aldosterone leads to higher levels of salt in the body which causes hypertension.

The current figures are that one-quarter of those above the age of 25 in Singapore have hypertension. This could lead on into heart and kidney disease and stroke if left untreated.

Most hypertension patients do not have a primary curable cause for their condition.

Clinical trials of this new procedure are still ongoing Clinical Imaging Research Centre at the National University of Singapore’s (NUS) Yong Loo Lin School of Medicine.

Professor Roger Foo of NUS and Adjunct Assistant Professor Troy Puar, of Changi General Hospital, are the researchers behind the trials.

Primary Aldosteronism

This condition exists such that the two small glands above the kidneys, called adrenal glands, create too much of the hormone aldosterone.

Out of those with this condition, half of them have tiny growths forming in just one of the glands. This gland can be removed with keyhole surgery, allowing for a higher possibility of a cure for the patient.

Presently, patients with such a condition are treated with an invasive procedure known as adrenal vein sampling (AVS).

It is conducted by inserting metal catheters into the patient’s groin to reach the veins and draw blood samples. It is a tough procedure that does not provide definite results in half of the patients.

Patients are usually required to stay overnight in the hospital as a result of this.

The new procedure, however, involves a patient being injected with a radioactive tracer. Abnormal hormone production will be highlighted in the process.

The scan can also detect small growths in a patient’s glands and show if they are producing too much aldosterone. This can be all done in less than an hour, without the need for an overnight stay at the hospital.

“Some patients have had high blood pressure for many years… there is so much damage to the blood vessels that this cannot be completely reversed… but at least they can take the same medication with much lower blood pressure, or have the same blood pressure with much less medication,” said Dr Puar.

The process for the procedure was first created in Sweden. Singapore is, however, the first country in Asia with the facilities for conducting the scan.

24 patients have gone through the new procedure here. A larger patient cohort validation is required before it can be ready for clinical use here.

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