Scientists find hidden cause of high blood pressure that routine tests can miss. Common and frequently missed cause may be easier to detect with help from wearable device that tracks hormone changes throughout day and night. New research published in Science Translational Medicine focuses on primary aldosteronism, hormone disorder that may affect up to one in five people with high blood pressure. Condition is associated with increased risk of heart disease, stroke, diabetes, and other serious health problems.
Researchers from University of Bristol and University of Manchester in UK, University of Bergen in Norway, and collaborators in Stockholm and Athens found people with primary aldosteronism can experience bursts of hormone production both during day and while asleep at night. Those nighttime surges are especially important because routine blood tests are rarely performed during sleep. Therefore, standard testing may miss diagnosis.
Wearable Device Tracks Hormones Around Clock At Home
To capture hidden changes, research team used portable device developed at University of Bristol that allowed patients to have hormone levels monitored continuously while living normally at home rather than staying in hospital or research facility. This type of continuous monitoring could reveal abnormalities that may be missed by conventional testing, potentially helping doctors identify hormone-related conditions earlier.
Study co-lead author Dr Thomas Upton, Clinical Research Fellow in Automated Sampling Clinical Fellow at University of Bristol, and Senior Clinical Fellow at Bristol Hospitals NHS Foundation Trust said: “Primary aldosteronism is important cause of high blood pressure and most common cause of secondary hypertension we see in our blood pressure clinic. It could be affecting millions of people in UK.”
“However, due to way hormones change during day and current complexity of diagnostic process, diagnosis is often delayed or never made at all. In our study, patients were monitored at home during normal activity, and this allowed us to see how hormones changed over time in realistic settings,” Upton explained.
“This approach could potentially revolutionize how we diagnose hypertension and ultimately reduce cardiovascular disease, particularly heart disease and strokes, that could have been prevented,” he added.
Measuring Hormones Every 20 Minutes With U-RHYTHM Device
Proof-of-concept study followed 60 patients in Bristol, Bergen, Stockholm, and Athens over 24-hour period. Hormone levels were measured every 20 minutes using lightweight wearable device about size of mobile phone that attaches at waist. Because device samples hormones from skin, participants were able to continue with usual activities, including sleeping at night, while researchers collected detailed hormone data.
Technology, known as U-RHYTHM, was adopted and further developed by spinout company Dynamic Therapeutics in 2023. Study senior author Dr Eder Zavala, UKRI Future Leader Fellow at University of Manchester, said: “By continuously monitoring hormones over 24 hours, we were able to reveal previously hidden pattern of nocturnal hormone bursts. This gives us much clearer understanding of disease and could ultimately help doctors detect it earlier and treat patients more effectively.”
“A more detailed mathematical and computational analysis of daily hormonal profiles could eventually also help uncover earlier and more subtle forms of disease, opening new opportunities to improve outcomes for patients living with high blood pressure,” Zavala added.
Why Standard Blood Tests May Miss Disorder Even In Severe Cases
Researchers used computational analysis to study changes in aldosterone, hormone that helps control salt and water balance in body. They also tracked two closely related hormones, 18-hydroxycortisol and 18-oxocortisol. Results suggest current diagnostic approaches may miss some patients because aldosterone does not remain consistently elevated.
Even in some of most severe cases, hormone levels sometimes dropped below minimum thresholds typically used to diagnose primary aldosteronism. Single blood test taken at one moment could therefore capture period when hormone levels appear relatively normal. Instead of remaining constantly high, aldosterone showed repeated bursts of secretion at night while overall day-night rhythm of hormone activity remained intact.
Analysis: Nighttime Hormone Bursts Offer New Clue For Diagnosis
Hormone spikes came from adrenal glands and were especially pronounced in patients whose primary aldosteronism was caused by problem affecting only one adrenal gland rather than both. Importantly, unusual hormone patterns disappeared after affected adrenal gland was surgically removed. That finding provided additional evidence bursts were directly associated with disease.
Study co-author Prof Stafford Lightman, Professor of Medicine at University of Bristol and inventor of U-RHYTHM technology, added: “Findings suggest clinicians may need to rethink how they look for disorder, which Endocrine Society clinical practice guidelines now recommend should be considered for all people with hypertension.”
“Future diagnosis could move away from single time point blood tests and towards tracking body’s hormone rhythms over time, particularly overnight patterns that appear to hold crucial clues to disease. Further research is needed to define best clinical pathways, using dynamic hormone measurement, to ensure early diagnosis of this common and potentially curable cause of high blood pressure,” Lightman said.
Toward Earlier Detection Of High Blood Pressure Causes
Findings raise possibility future testing for primary aldosteronism could rely less on single blood sample and more on monitoring how hormones change over time.
Because disorder can be treated and, in some cases, potentially cured with surgery or medication, detecting it earlier could help reduce risk of preventable cardiovascular complications.
Wearable hormone tracking at home may revolutionize hypertension diagnosis and prevent heart disease and strokes that could have been avoided.
Q&A
Q: What hidden cause of high blood pressure can routine tests miss?
A: Primary aldosteronism hormone disorder may affect 1 in 5 hypertensives; aldosterone bursts at night are missed by daytime blood tests.
Q: How did wearable device detect hidden hypertension cause?
A: U-RHYTHM wearable measured hormones every 20 minutes for 24 hours at home, revealing nocturnal aldosterone bursts even in severe cases.
Q: Is primary aldosteronism curable?
A: Yes, in some cases especially when one adrenal gland affected, surgical removal cures condition; early detection reduces heart disease and stroke risk.
FAQ
1. Where was wearable hypertension study published?
Study published in Science Translational Medicine by University of Bristol, Manchester, Bergen, Stockholm and Athens researchers using U-RHYTHM device.
2. How many patients were monitored with wearable?
Proof-of-concept study followed 60 patients over 24 hours across Bristol, Bergen, Stockholm, Athens measuring hormones every 20 minutes.
3. What is primary aldosteronism?
Hormone disorder where adrenal glands produce excess aldosterone affecting salt and water balance, most common cause of secondary hypertension.
4. Why do blood tests miss primary aldosteronism?
Aldosterone shows bursts not constant high levels, sometimes dropping below diagnostic thresholds; single time-point test can appear normal.
5. What is U-RHYTHM technology?
Lightweight waist-worn device size of mobile phone that samples hormones from skin continuously; developed at Bristol and now by Dynamic Therapeutics.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult qualified healthcare professionals or hypertension specialists for high blood pressure diagnosis and treatment. Do not stop blood pressure medications or seek adrenal surgery based on this article.
