Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

A new scan to detect and cure the commonest cause of high blood pressure

qmul.ac.uk

Post reply on HN
Print view View original

31–40 of 92 posts

Re: A new scan to detect and cure the commonest cause of high blood pressure

#31

Post by golem14 »

jabroni_salad wrote: post #29
ClumsyPilot wrote: post #20

Earlier quoted context omitted.

isn't a single CT scan and surgery cheaper than 40 years of medication?

It really depends on the surgery. Heart surgery isn't exactly minor and doctors do tend to prefer non-invasive treatment. I like to minimize on my needed medications though. I would probably opt for this if it were available.

Isn't the described remedial procedure to take a radioactive substance that will burn out the nodules ?) That's not that expensive or invasive.

I understand something similar is done for Morbus Basedow / Grave's disease with the thyroid gland.

Re: A new scan to detect and cure the commonest cause of high blood pressure

#32

Post by golem14 »

Rebelgecko wrote: post #26
ClumsyPilot wrote: post #20

Earlier quoted context omitted.

isn't a single CT scan and surgery cheaper than 40 years of medication?

Probably not. The sticker price of my blood pressure medicine comes out to like $60/yr. The scan alone would probably cost more than 40 years of medication (and the #s are potentially much worse if you consider time value of money and all that)

Cost to you, or combined cost for you / insurer ? Honest question.

Re: A new scan to detect and cure the commonest cause of high blood pressure

#33

Post by Traubenfuchs »

golem14 wrote: post #31
jabroni_salad wrote: post #29

Earlier quoted context omitted.

It really depends on the surgery. Heart surgery isn't exactly minor and doctors do tend to prefer non-invasive treatment. I like to minimize on my needed medications though. I would probably opt for this if it were available.

Isn't the described remedial procedure to take a radioactive substance that will burn out the nodules ?) That's not that expensive or invasive. I understand something similar is done for Morbus Basedow / Grave's disease with the thyroid gland.

The linked article references "surgically curable primary aldosteronism".

You are probably referencing "radioiodine therapy" which is highly specific to thyroid issues.

Re: A new scan to detect and cure the commonest cause of high blood pressure

#34

Post by pfdietz »

jessriedel wrote: post #25

Journal article: Wu et al., "11C-metomidate PET CT versus Adrenal Vein Sampling for diagnosing surgically curable primary aldosteronism: prospective test validation, and impact of somatic genotype and ethnicity on outcomes" https://assets.researchsquare.com/files/rs-1179128/v1_covere... Metomidate is a molecule (C_13 H_14 N_2 O_2) that naturally collects in the adrenal glands, and 11C-metomidate is a version where so…

That tracer has to be made on site, since 11C has a halflife of 20 minutes. So there has to be a particle accelerator to make the 11C and a chemistry lab to quickly get the 11C into the drug.

Re: A new scan to detect and cure the commonest cause of high blood pressure

#36

Post by trynewideas »

ClumsyPilot wrote: post #20
Traubenfuchs wrote: post #17

Earlier quoted context omitted.

- this only concerns 5 - 10% of all hypertension patients - ~50% of adult Americans have hypertension - scanning all medication-non-responders (= people suffering from "resistant hypertension") and operating on all of them to remove the causative nodules sounds like quite the tall order - doctors won't just suddenly start sending all the resistant hypertension patients to CTs to diagnose this cause, instead they will…

isn't a single CT scan and surgery cheaper than 40 years of medication?

The article/headline is confusing; the real comparison is between a non-invasive PET-CT scan using metomidate as an imaging medium, and invasive and specialized adrenal vein sampling (AVS), both as diagnostic tools.

AVS is correlated using a non-metomidate adrenal CT scan anyway, so a CT-only option would be less expensive and could be performed in more facilities, making it more accessible:

> Until now, 99% are never diagnosed because of the difficulty and unavailability of tests.

And since AVS has such a low predictive success rate (63% per the study), the CT-scan-only alternative doesn't even have to be good, it just has to be about as bad as AVS.

The results of either could very well be "keep taking meds for 40 years" or "surgery helps immensely", but the real cost savings are in avoiding AVS and also potentially diagnosing and treating more people sooner.

(Also mind that the study's done in the UK, where CT scans cost patients about £800/US$1,000 even when done privately, and in Scotland/Wales/N. Ireland the meds are free to the patient. In the US, a CT scan averages about $5,000, $12,000 isn't unheard of, and the meds cost $7,000-$20,000 for 40 years.)

Re: A new scan to detect and cure the commonest cause of high blood pressure

#37

Post by fareed79 »

This is not a CT but a PET scan, it records passive radiation from a molecule injected into the body, and therefore a 10 min long scan. Then it is based on radioactive carbon (C-11), which is pretty uncommon and needs quick use after production, so not every PET(CT) can do that, it needs be in the vicinity of a production facility (i.e. close to a university/research hospital). This is the sense of the last sentence: it needs a replacement the carbon with another radioactive isotope (fluor for instance) to be doable at every PET/CT place. I don't blame the title here, because the article itself is very strangely written, it says as well "CT scan" but this is no "CT scan", this is a PET scan.

Re: A new scan to detect and cure the commonest cause of high blood pressure

#38

Post by SoftTalker »

selimthegrim wrote: post #4

I wonder if US healthcare with its profusion of CT scanners can drive down long term patient treatment costs faster with their greater installed base.

I don't know about that. I currently need an MRI and the earliest appointment I could get was 4 weeks out, and that's not at the closest facility (they are nearly two months out). Maybe CT scans are faster.

Re: A new scan to detect and cure the commonest cause of high blood pressure

#39

Post by mikeyouse »

golem14 wrote: post #32
Rebelgecko wrote: post #26

Earlier quoted context omitted.

Probably not. The sticker price of my blood pressure medicine comes out to like $60/yr. The scan alone would probably cost more than 40 years of medication (and the #s are potentially much worse if you consider time value of money and all that)

Cost to you, or combined cost for you / insurer ? Honest question.

Most blood pressure medication is dirt cheap, effective pills have been generic for decades now -- you can get a 3-month supply of the largest dose of lisinopril for under $10 cash (no insurance).

https://costplusdrugs.com/medications/lisinopril-2_5mg-table...

Re: A new scan to detect and cure the commonest cause of high blood pressure

#40

Post by QuercusMax »

dang wrote: post #16
yjftsjthsd-h wrote: post #5

Hilariously, I think the HN anti-clickbait filter made this title more clickbaity: The original title was "Ten-minute scan enables detection and cure of the commonest cause of high blood pressure", which HN helpfully removed the number from... leading to "Minute scan detects and cures of most common cause of high blood pressure". And a one minute scan would be even more impressive, but that's not what it is...

Yes, that happens sometimes. I've changed it to clearer language from the first paragraph.

The current title is also wrong: it's not a CT scan, but rather a PET/CT scan (with the emphasis on the PET, which requires injection with a radiotracer).
Post reply on HN