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Research led by scientists at the University of Birmingham has revealed a new cause of high blood pressure which could lead to major changes in managing the disease.

High blood pressure, also known as hypertension, often goes unnoticed but if left untreated can increase the risk of heart attack and stroke.

Studies estimate that one in four adults suffer from hypertension, but most patients have no identifiable cause for the condition.

However, it is known that in up to 10 per cent of hypertensive patients the overproduction of the adrenal hormone aldosterone,a condition known as primary aldosteronism or Conn syndrome,is the cause of disease.

Primary aldosteronism or Conn’s syndrome is any of a number of disorders that directly cause the adrenal glands to overproduce aldosterone The symtoms of the condition tend to be mild and prosaic such as high blood pressure,poor vision, headaches, muscle weakness, spasms,peripheral neuropathy and excess urination.

Although an estimated 1 of 4 adults have hypertension, most patients have no identifiable cause for the condition. However, in up to 10% of patients with hypertension the cause of the disease is Conn syndrome: the overproduction of the adrenal hormone aldosterone.

But in a new study, investigators found that in addition to the overproduction of aldosterone in patients with Conn syndrome, they also produce too much cortisol. The investigators dubbed this new cause of hypertension Connshing syndrome.

About 10% of patients with high blood pressure also have Conn’s. It is more common in women, and usually is first diagnosed in patients over 30 but under 50. In addition, about 40% of patients have been identified with a common gene even in non-genetic cases.

The authors of the University of Birmingham-led study, conducted in collaboration with a group of scientists from Germany, decided to name this new cause of hypertension,the combined overproduction of aldosterone and cortisol,as Connshing syndrome.

Professor Wiebke Arlt, Director of the Institute of Metabolism and Systems Research (IMSR) at the University of Birmingham, said: “Our findings show that the adrenal glands of many patients with Conn syndrome also produce too much cortisol, which finally explains puzzling results of previous studies in Conn patients.

“These previous studies had found increased rates of type 2 diabetes, osteoporosis and depression in Conn patients, problems typically caused by overproduction of cortisol, also termed Cushing syndrome, and not by too much aldosterone.”

“Patients will now need to undergo more detailed assessment to clarify whether they suffer from Conn or Connshing syndrome.

“Previously, patients with Conn syndrome were never assessed for the overproduction of other hormones but this will now change thanks to the results of this study.

“Also, researchers now will need to investigate whether treating the Connshing patients with an additional drug, which counteracts the cortisol excess, will improve their health outcomes.”


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