Research breakthrough in hypertension: Birmingham leads pan-European effort

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 and in ten per cent of these adults, it is due to the overproduction of the adrenal hormone aldosterone, a condition known as primary aldosteronism or Conn syndrome.

A University of Birmingham-led study has for the first time discovered that a large number of patients with c do not only overproduce aldosterone, but also produce the stress hormone cortisol. This explains why previous studies 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. The Birmingham team of researchers named the new cause of hypertension, as Connshing syndrome. The discovery is highly likely to change clinical practice. At present, many Conn syndrome patients are treated with drugs directed against the adverse effects of aldosterone, which leaves the cortisol excess untreated.

Birmingham academics made this game-changing research a success; not only by having a great team and looking outside the box for answers, but translating their findings into meaningful health outcomes. In addition, the success of the discovery depended on two major factors. Firstly, the University of Birmingham Metabolomics Core, which offers a unique capacity to analyse human hormone production in unprecedented detail, enabling the discovery to be made.

Secondly, the success of the research also depended upon pan-European collaborations, both for rapid patient recruitment and unique basic science research capacity, immediately accessible thanks to European research funding. In Horizon 2020, the European research and innovation programme of the European Union (EU), the University of Birmingham is currently positioned as the 14th most successful Higher Education Institution (HEI) in Europe, at securing EU research projects. Research is then not only funded, but accelerated by access to collaborations that no UK-based funding mechanism can leverage. To that end, modern science is a ‘team’ game and bringing together the best will undoubtedly help push science forward. In the case of biomedical science, this significantly shortens the time it takes to translate research into clinical practice.

The recently published report commissioned by the Royal Society and the Academy of Medical Sciences documents that UK HEIs collectively reported around £725 million in research grant income from EU government bodies in 2014/15. According to data provided by the Higher Education Statistics Agency (HESA), clinical medicine is leading this league table. This equates to 12 per cent of UK HEIs’ £5.9 billion in research income, or around 25 per cent of the £2.75 billion in research grants currently provided by the UK government through bodies such as Innovate UK and the seven grant-awarding research councils.

We don’t yet know what will happen to UK researchers’ access to EU funding other than a guarantee by the UK government to cover the next three years. The potential permanent loss of an equivalent of 25 per cent of overall research funding through the EU cannot be replaced by money alone, if it were available. UK researchers also face losing access to pan-European collaboration, the meeting of the greatest minds across the continent and thanks to indiscriminate immigration targets, unhindered mobility of the best young researchers to UK research centres.

Our researchers are keen to take forward their work on Connshing syndrome and aim to investigate if additional treatment targeting the cortisol excess improves health outcomes. However, without the opportunity of sustained European collaboration, this next step in translating this research breakthrough into clinical practice may take a lot longer.
Action needs to be taken in order to secure funded access of UK researchers to the EU research and innovation programme and should be made a top priority in the Brexit negotiations.

As a just published report states, while negotiations begin on a new relationship between the UK and the EU, it is vital that they result in the best possible outcome for science and patients across the EU and the UK.


Professor Wiebke Arlt
William Withering Chair of Medicine, Institute of Metabolism and Systems Research