Friday 17 May is World Hypertension Day. High blood pressure is the number 1 contributing risk factor for global death and can cause strokes, heart attacks and other cardiovascular complications – over 10 million lives are lost each year around the world due to high blood pressure. For most people, there are no warning signs for high blood pressure, which is why it’s so important to get it checked regularly.
Monash Health’s Endocrine Hypertension Unit was established 2010 and has received international success and recognition. The team is headed by Dr Jun Yang, an Endocrinologist at Monash Health and post-doctoral researcher at Hudson Institute of Medical Research and School of Clinical Science at Monash University. The multidisciplinary collaboration between Endocrinology including Dr Jun Yang, Dr Jimmy Shen, Prof Peter Fuller, Radiology (A/Prof Winston Chong) and Biochemical Pathology (A/Prof Jim Doery) has been achieving world best outcomes in adrenal vein sampling (AVS), a vital part of the management of patients with primary aldosteronism (PA).
This May Dr Jun Yang and A/Prof Winston Chong were invited by the largest PA research consortium in China (CONPASS) to speak at the International Endocrine Hypertension Conference in Chongqing. Jun and Winston presented on the rigorous process of PA diagnosis at Monash with a special focus on techniques to improve the success of AVS. Their seminars were very well received, so much so that the CONPASS group intends to standardise their AVS methods in line with the Monash protocol. This is a testament to the Unit’s world class achievements.
PA is a potentially curable and under-diagnosed form of hypertension that is estimated to affect 10 % of the 6 million patients in Australia diagnosed with hypertension. Statistics underline the importance of this service, but it is the stories from Monash patients that motivate members of the team to strive for excellence in clinical care. Typical of the grateful patients seen in the clinic is Mr AB who had suffered from resistant hypertension for years and now after curative surgery a few weeks ago feels “like a new man” with a reduction in blood pressure from a dangerous level above 180/110 whilst on 4 medications to now having a normal BP of 120/70 on a single low dose of medicine only.
AVS is a technically challenging procedure that determines which of the two adrenal glands is producing excess aldosterone (which in turn causes the hypertension and raised cardiovascular risk). Successful AVS that demonstrates involvement of a single adrenal gland will enable a surgical cure via laparoscopic “keyhole” surgery by specialist Endocrine Surgeons at Monash Health. If both adrenal glands are affected, then a targeted medication can be used to block the effects of aldosterone.
A diagnosis of PA presents one of the few opportunities to cure hypertension and identify its root cause. A simple blood test followed by AVS testing at centres such as the Monash Endocrine Hypertension Unit could prevent disability and premature death caused by stroke or heart attack in as many as 600,000 Australians.
Image: Dr Jun Yang and A/Prof Winston Chong with the Chinese PA research group at the Endocrine Hypertension Conference in Chongqing China, on 11 May 2019.