News Release

Cause and cure discovered for common type of high blood pressure

Clinicians at Queen Mary University of London and Barts Hospital have identified a gene variant that causes a common type of hypertension (high blood pressure) and a way to cure it, new research published today in Nature Genetics shows.

Peer-Reviewed Publication

Queen Mary University of London

The cause is a tiny benign nodule, present in one-in-twenty people with hypertension. The nodule produces a hormone, aldosterone, that controls how much salt is in the body. The new discovery is a gene variant in some of these nodules which leads to a vast, but intermittent, over-production of the hormone.  

The gene variant discovered today causes several problems which makes it hard for doctors to diagnose some patients with hypertension. Firstly, the variant affects a protein called CADM1 and stops cells in the body from ‘talking’ to each other and saying that it is time to stop making aldosterone. The fluctuating release of aldosterone throughout the day is also an issue for doctors, which at its peak causes salt overload and hypertension. This fluctuation explains why patients with the gene variant can elude diagnosis unless they happen to have blood tests at different times of day. 

The researchers also discovered that this form of hypertension could be cured by unilateral adrenalectomy – removing one of the two adrenal glands. Following removal, previously severe hypertension despite treatment with multiple drugs disappeared, with no treatment required through many subsequent years of observation. 


Fewer than 1% of people with hypertension caused by aldosterone are identified because aldosterone is not routinely measured as a possible cause. The researchers are recommending that aldosterone is measured through a 24-hour urine test rather than one-off blood measurements, which will discover more people living with hypertension but going undiagnosed.  

The initial patient in this study was detected when doctors noticed fluctuation in his hormone levels during his participation in a clinical trial of treatments for difficult hypertension. 

In most people with hypertension, the cause is unknown, and the condition requires life-long treatment by drugs. Previous research by the group at Queen Mary discovered that in 5-10% of people with hypertension the cause is a gene mutation in the adrenal glands, which results in excessive amounts of aldosterone being produced. Aldosterone causes salt to be retained in the body, driving up the blood pressure. Patients with excessive aldosterone levels in the blood are resistant to treatment with the commonly used drugs for hypertension, and at increased risk of heart attacks and strokes.  

Professor Morris Brown, co-senior author of the study and Professor of Endocrine Hypertension at Queen Mary University of London, said: “ 

 “In the 900th anniversary of Barts Hospital, this story illustrates benefits from the virtuous circle of Science and Medicine. Most patients consent to our undertaking non-routine molecular analyses of their surgical samples, from which we discover how their hypertension was caused, and how to cure it in future patients. Because the aldosterone nodules in this study were so small, we are now investigating whether momentary cauterisation of the nodule is an alternative to surgical removal of the whole adrenal gland.” 

The research at Queen Mary was funded by Barts Charity and undertaken by research fellows funded by the British Heart Foundation, National Institute of Health Research, Medical Research Council and Royal Society. The team collaborated with laboratories in Munich, Paris and Michigan to find further people with the new variant, and in Osakasayama, Japan, KL, Malaysia, and Pittsburgh, USA, to better understand its effect on the body.  




Notes to editors 

Research paper: Wu et al. Somatic mutations of CADM1 in aldosterone-producing adenomas and gap junction-dependent regulation of aldosterone production.  

Link to paper available after embargo lifts: 

For more information, please contact: Lee Pinkerton - Faculty Communications Officer (Medicine and Dentistry) Queen Mary University of London    

Tel: +44 (0) 7985 446 280 


Professor Brown and the index patient previously participated in a BBC Inside Health podcast regarding the diagnosis and cure of Primary Aldosteronism. This is available at  





About Queen Mary University of London 

  • At Queen Mary University of London, we believe that a diversity of ideas helps us achieve the previously unthinkable. 

  • Throughout our history, we’ve fostered social justice and improved lives through academic excellence. And we continue to live and breathe this spirit today, not because it’s simply ‘the right thing to do’ but for what it helps us achieve and the intellectual brilliance it delivers. 

  • Our reformer heritage informs our conviction that great ideas can and should come from anywhere. It’s an approach that has brought results across the globe, from the communities of east London to the favelas of Rio de Janeiro. 

  • We continue to embrace diversity of thought and opinion in everything we do, in the belief that when views collide, disciplines interact, and perspectives intersect, truly original thought takes form. 


About Barts Charity 

  • Barts Charity is dedicated to supporting improvements to healthcare and transformative research with a primary focus on the issues that matter to the people of East London. It does this by funding high-quality research, innovative patient care projects and NHS staff wellbeing initiatives that would otherwise not be funded by the NHS or other funders. 

  • It focuses its funding on supporting Barts Health NHS Trust, which runs St Bartholomew’s, The Royal London, Mile End, Whipps Cross and Newham Hospitals, and the Faculty of Medicine and Dentistry at Queen Mary University of London, where there are six medical research institutes. We also support researchers at the School of Health Sciences at City, University of London. 


About the British Heart Foundation 

It is only with donations from the public that the BHF can keep its life saving research going. Help us turn science fiction into reality. With donations from the public, the BHF funds ground-breaking research that will get us closer than ever to a world free from the fear of heart and circulatory diseases. A world where broken hearts are mended, where millions more people survive a heart attack, where the number of people dying from or disabled by a stroke is slashed in half. A world where people affected by heart and circulatory diseases get the support they need. And a world of cures and treatments we can’t even imagine today. Find out more at 


The National Institute for Health and Care Research (NIHR) 

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by: 

  • Funding high quality, timely research that benefits the NHS, public health and social care; 

  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services; 

  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research; 

  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges; 

  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system; 

  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries. 

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government. 




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