Endocrine Hypertension Research Centre

Major areas of the Centre's ongoing research and research collaborations in this and other fields include: 

• optimisation of the detection, diagnostic workup and management of patients with PA 
• clinical, biochemical and genetic aspects of a glucocorticoid-suppressible, familial variety of PA (familial hyperaldosteronism type I, FH-I), including the determinants of hypertension severity in this disorder 
• searching for genetic mutations responsible for a second familial variety of PA (FH-II - in collaboration with Drs David Duffy and Grant Montgomery, Queensland Institute of Medical Research; A/Prof Constantine Stratakis, Bethesda, Maryland, USA; Professor Francesco Fallo, Padova, Italy; Dr Paulo Mulatero, Torino, Italy; Professor Maria New, New York, New York, USA; Dr Kevin O'Shaughnessy, Cambridge, UK; and Prof Matthew Brown, University of Queensland Diamantina Institute & Institute of Molecular Biosciences) which the Centre described for the first time in the early 1990's 
• development of a new, highly accurate and reproducible aldosterone assay system using mass spectrometry 
• non-blood pressure-dependent adverse effects of aldosterone excess (in collaboration with Professor Thomas Marwick, formerly University of Queensland and now Cleveland Clinic), including the role of salt in the generation of aldosterone-induced injury 
• pathophysiology and genetics of Gordon's syndrome, condition characterized by familial hypertension and high blood potassium levels and which was named after the EHRC's founder  (work being performed in collaboration with Dr Kevin O'Shaughnessy, Cambridge, UK).

Achievements

The Centre has in recent years placed particular emphasis on epidemiological, biochemical, morphological and genetic aspects of primary aldosteronism (PA) and has attracted much attention for its work in this area. It demonstrated 19 years ago that this potentially curable condition is approximately ten times more common than previously thought, a finding which has led to the identification of thousands of patients who would otherwise have gone undetected, and in whom hypertension has been cured or markedly improved following surgical or specific medical treatment. It also described the phenotypic characteristics of a common but rarely recognised tumorous form (angiotensin-II responsive aldosterone-producing adenoma) and a new and more common familial variety (familial hyperaldosteronism type II, FH-II). It has contributed to the diagnosis, pathophysiology and treatment of the first described, rare, familial form of PA (FH-I) which is glucocorticoid-remediable.

Research at the Centre has demonstrated evidence of non-blood pressure related adverse cardiovascular effects of aldosterone excess in normotensive subjects with FH-I in collaboration with Professor Tom Marwick, University of Queensland Department of Medicine, Princess Alexandra Hospital using state-of-the-art echocardiographic techniques to study fibrosis and remodelling of the heart. Ongoing studies are focussing on the interaction of aldosterone and salt in the generation of disease states (including cardiac hypertrophy, renal damage and obstructive sleep apnoea) in patients with PA.