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Member Research & Reports

Member Research & Reports

Michigan Research: Adrenals Run Amok: Discovery Could Aid Precision Medicine for High Blood Pressure

Each of your kidneys wears a little yellow cap that helps keep your blood pressure in check, and much more. But in some people, it starts running amok, pumping out a hormone that sends blood pressure sky-high.

Why this happens is still a mystery. But new findings could help figure out what’s going on – causing one in 10 cases of high blood pressure, and affecting one in every 50 adults. And further research could improve diagnosis and treatment.

Left unchecked, the high pressures caused by the extra amounts of the hormone called aldosterone can harm the heart, kidneys and much more. In fact, this form of hypertension can inflict even more damage than other forms of high blood pressure.

The new University of Michigan research could aid the search for tools to precisely target the condition, called primary aldosteronism or PA. Right now, many people with PA never get an accurate diagnosis or proper treatment. The findings are published in the Proceedings of the National Academy of Sciences.

The new findings actually suggest that many of us have small clusters of cells in our adrenal glands that have mutations that could lead to PA, even though we don’t have the condition. As many as one in five of us could have elevated aldosterone as a result.

By studying the adrenal glands of healthy kidney donors, the U-M team found mutations that allow clusters of cells to make aldosterone — outside of the normal process that tightly controls its production to regulate blood pressure. This will help them zero in on the origins of PA, and figure out what factors allow it to arise out of clusters of cells called APCCs.

“Our findings suggest that most of us have these origins of PA in our adrenals already, in the form of cell-level mutations that cause dysregulation of hormone production but aren’t severe enough to lead to disease,” says Dr. William Rainey, senior author and professor of Molecular and Integrative Physiology and Internal Medicine. “We believe they are the first step toward full-blown disease, and are more common in women than in men.”

Mr. Rork Kuick, statistician expert, U-M School of Public Health, is a co-author on the study.

For more information, including a list of co-authors, click here.