Nighttime hormone spikes may reveal a hidden cause of high blood pressure. New research suggests continuous monitoring may uncover hormone patterns that routine blood tests can miss.
Some people with high blood pressure may have an underlying hormone disorder that routine testing can miss, according to new research published in Science Translational Medicine.
The study found that patients with primary aldosteronism can experience repeated bursts of hormone production, particularly during the night, when conventional blood tests are rarely performed. (1✔ ✔Trusted Source
Tissue corticosteroid rhythms are dysregulated predominantly during sleep in primary aldosteronism
)
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What Is Primary Aldosteronism?
Primary aldosteronism (2✔ ✔Trusted Source
Primary Aldosteronism (Conn’s Syndrome)
) occurs when the adrenal glands produce too much aldosterone, a hormone that helps regulate salt and water balance in the body.
The condition is estimated to affect up to one in five people with high blood pressure and is associated with a higher risk of cardiovascular problems, including heart disease and stroke.
The adrenal glands sit above the kidneys and produce several hormones, including aldosterone. When too much aldosterone is produced, it can cause the body to retain more sodium and water, contributing to high blood pressure.
Because primary aldosteronism can be treated when the underlying cause is identified, detecting the condition earlier could be important for preventing complications. The researchers noted that current clinical guidelines recommend considering primary aldosteronism in people with hypertension.
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Why Could Primary Aldosteronism Go Undetected?
Unlike conditions in which hormone levels remain consistently elevated, the researchers found that aldosterone levels in primary aldosteronism can fluctuate throughout the day.
In some patients, hormone levels even dropped below the thresholds typically used to identify the disorder. This means a single blood test could potentially be taken at a time when hormone levels appear normal, making the condition harder to detect.
The researchers instead observed repeated hormone bursts during the night, while the body’s normal day-night rhythm remained intact. These bursts involved aldosterone as well as two related hormones, 18-hydroxycortisol and 18-oxocortisol.
The nighttime hormone spikes were particularly noticeable in people whose primary aldosteronism was caused by a problem affecting only one adrenal gland.
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How Did Researchers Detect the Hidden Hormone Spikes?
The study used a wearable device called U-RHYTHM, which allowed researchers to monitor hormone levels continuously while participants went about their normal daily lives.
The proof-of-concept study involved 60 patients from Bristol, Bergen, Stockholm and Athens. Hormone levels were measured every 20 minutes over a 24-hour period.
The lightweight device, roughly the size of a mobile phone, was worn around the waist and collected measurements from the skin. This approach allowed researchers to observe hormone changes during everyday activities, including sleep—something that conventional testing may not capture.
Why Is Nighttime Hormone Activity Important?
The discovery of nighttime hormone bursts could help explain why some cases of primary aldosteronism are missed. The researchers found that the abnormal hormone pattern disappeared after surgical removal of the affected adrenal gland in patients whose condition was linked to one adrenal gland. This provides additional evidence that the hormone bursts were connected to the disease.
The results suggest that when a hormone is measured may be just as important as the hormone level itself. Instead of relying only on a single blood sample, future testing could potentially examine hormone patterns over an extended period, particularly overnight changes.
Could Wearable Technology Change Hypertension Diagnosis?
The researchers say continuous hormone monitoring could eventually provide a more detailed picture of how hormonal disorders develop and behave throughout the day.
Dr. Eder Zavala of the University of Manchester said continuous monitoring revealed a previously hidden pattern of nighttime hormone bursts and could ultimately help clinicians detect and treat the condition earlier. However, the technology is still being investigated.
The study was a proof-of-concept investigation, and further research is needed to determine how dynamic hormone monitoring could be incorporated into routine clinical care.
What Does the Study Mean for People With High Blood Pressure?
The research does not mean that everyone with high blood pressure has primary aldosteronism. Instead, it highlights why some cases of secondary hypertension may be difficult to identify using conventional, single-time-point testing. The findings raise the possibility that tracking hormone rhythms over 24 hours could provide additional clues that a single blood test misses.
Future studies will need to determine whether this approach can improve diagnosis in routine clinical settings and whether earlier identification and treatment can reduce cardiovascular complications.
References:
- Tissue corticosteroid rhythms are dysregulated predominantly during sleep in primary aldosteronism – (https://www.science.org/doi/10.1126/scitranslmed.aeb7517)
- Primary Aldosteronism (Conn’s Syndrome) – (https://my.clevelandclinic.org/health/diseases/21061-conns-syndrome)
Source-Medindia