Endocrine Hypertension Research Centre

	Profile

The Endocrine Hypertension Research Centre, based at Greenslopes and Princess Alexandra Hospitals within the University School of Medicine, conducts internationally acclaimed research into the causes and management of various forms of hypertension (high blood pressure), including curable and specifically treatable varieties.

Established by Professor Richard Gordon and currently co-directed by Professor Gordon and Professor Michael Stowasser, the Endocrine-Hypertension Research Centre has attained a high international reputation for its clinical and research experience in the pathogenesis, diagnostic workup and management of various forms of hypertension and especially of endocrine varieties, including primary aldosteronism (PAL), renovascular hypertension, pheochromocytoma, renin-secreting tumors, and the syndrome (which bears Professor Gordon's name) of hypertension and hyperkalemia with normal glomerular filtration rate.

In recent years, the Centre has placed particular emphasis on epidemiological, biochemical, morphological and genetic aspects of PAL and has attracted much attention for its work in this area. The Centre demonstrated that PAL is approximately ten times more common than previously thought, a finding which has led to the identification of thousands of patients in whom hypertension has been rendered cured or markedly improved following surgical or specific medical treatment.

It also described the phenotypic characteristics and genetic basis of a new tumorous form (angiotensin-II responsive aldosterone-producing adenoma) and a new familial variety (familial hyperaldosteronism type II, FH-II). It has made key contributions to the understanding of steroid and BP regulation in, and treatment of, another familial form of PAL (FH-I) which is glucocorticoid-remediable, and for which the Centre designed a rapid new method of genetic detection.

Current research activities of the Centre have involved:

• Epidemiological, clinical, biochemical, morphological and genetic aspects of PAL.
  Using meticulous new approaches to diagnose PAL, the Centre has accumulated the largest number of patients (currently over 1000) with PAL worldwide who have been thoroughly studied and documented. This provides a unique resource for further research into the causes, diagnosis and treatment of mineralocorticoid hypertension. The Centre is the only facility in Eastern Australia offering genetic testing for FH-I which can cause severe hypertension but is easily controlled by giving small doses of "glucocorticoid" medication.
  
  
• Genetic forms (i) FH-I: clinical, biochemical and genetic approaches to detection, various aspects of aldosterone biosynthesis, determinants of hypertension severity, treatment, and seeking evidence of non-blood pressure related adverse effects of aldosterone excess in normotensive subjects with FH-I.
  
  
• Genetic forms (ii) the Centre is involved in collaborative research with the Queensland Institute of Medical Research, and the National Institutes of Health, Bethesda and Cornell University, New York, USA in order to determine genetic mutations responsible FH-II, which was first described by the Centre in 1991.
  
  
• Non-BP dependent adverse cardiovascular effects of aldosterone excess, which are being sought in patients with PAL and other forms of hypertension by measuring procollagen propeptides and pulse wave velocity, and using state-of-the-art echocardiographic techniques performed in Professor Thomas Marwick's laboratory, UQ Discipline of Medicine, Princess Alexandra Hospital.
  
  
• The genetic basis of fibromuscular dysplasia of the renal arteries, which causes a renovascular form of hypertension.
  
  
• The detailed pathophysiology and genetic basis of Gordon's syndrome.
  
  
• The diagnosis of renin-secreting tumors.
  
  
• Pathogenesis and diagnosis of pheochromocytoma, a tumor that secretes catecholamines (including adrenaline and noradrenaline), leading to extremely dangerous hypertension.
  
  
• Involvement in carefully selected clinical trials evaluating the newest forms of drug treatment.

	Links

	Keywords