20-Minute ‘Heat Zap’ Treatment Could Free Millions From High Blood Pressure Pills

A 20-minute procedure that destroys problematic adrenal nodules through targeted heat therapy could offer freedom from blood pressure medications for millions worldwide. The minimally invasive treatment, developed by UK researchers, provides a tantalizing alternative to major surgery for a commonly overlooked hormonal condition.

The new approach, tested across three major UK hospitals, uses a tiny needle guided by ultrasound to precisely target and destroy small hormone-producing nodules that can cause severe high blood pressure. The procedure requires no incisions and allows patients to return home the same day – a stark contrast to the current treatment requiring complete surgical removal of the adrenal gland.

In findings published in The Lancet, researchers demonstrated the procedure’s safety and effectiveness in 28 patients. Most participants showed normal hormone levels six months later, with some able to completely stop their blood pressure medications.

“It is 70 years since the discovery in London of the hormone aldosterone,” said Professor Morris Brown, co-senior author and Professor of Endocrine Hypertension at Queen Mary University of London. He noted that this advancement finally realizes a long-held prediction about treating this form of high blood pressure, adding that they are now “offering 21st-century breakthroughs in diagnosis and treatment.”

The condition, known as primary aldosteronism, affects approximately one in twenty people with high blood pressure. It occurs when small benign nodules in the adrenal glands produce excess aldosterone, a hormone that raises blood pressure by increasing the body’s salt levels. Despite its prevalence, fewer than one percent of cases are currently diagnosed.

For trial participant Michelina Alfieri, the treatment provided immediate relief from long-standing symptoms. “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,” she said. “This non-invasive treatment provided an immediate recovery—I was back to my normal routine straight away.”

The new technique, formally known as endoscopic ultrasound-guided radiofrequency ablation, works by passing a tiny camera through the mouth into the stomach. Using ultrasound imaging, doctors can then precisely guide a needle to the problematic nodule and deliver short bursts of heat that destroy it while leaving surrounding healthy tissue unharmed.

Professor Stephen Pereira, Chief Investigator of the study and Professor of Hepatology & Gastroenterology at UCL Institute for Liver and Digestive Health, highlighted the procedure’s potential widespread application: “With appropriate training, this less invasive technique could be widely offered in endoscopy units across the UK and internationally.”

The success has prompted a larger trial called ‘WAVE’, which will compare this new approach with traditional surgery in 120 patients. Results are expected in 2027.

“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,” said Professor Mark Gurnell, Clinical Endocrinology Lead at Addenbrooke’s Hospital and Professor of Clinical Endocrinology at the University of Cambridge.

The research was supported by Barts Charity, the National Institute for Health and Care Research through the Barts and Cambridge Biomedical Research Centres, and the British Heart Foundation. The advancement could represent a significant shift in treating this form of high blood pressure, offering hope to millions who currently go undiagnosed and untreated.