Wearable Hormone Monitor Enables At-Home Detection of Primary Aldosteronism

Many cases are missed because routine testing is infrequent and hormone levels fluctuate over the day and night. Delayed or absent diagnosis leaves patients exposed to preventable cardiovascular harm. A new study shows that continuous, at-home hormone monitoring with a wearable can uncover hidden spikes that signal the condition earlier.

Researchers at the University of Bristol developed the U-RHYTHM wearable and evaluated it with collaborators at the University of Manchester, the University of Bergen, and partner institutions in Stockholm and Athens. The system enables 24-hour hormone profiling during normal daily activities, with the goal of revealing disease-related hormonal rhythms that conventional clinic-based testing may miss.

U-RHYTHM is a lightweight, waist-worn device about the size of a mobile phone. It samples hormones from the skin every 20 minutes while patients continue their usual activities and sleep overnight. This continuous sampling generates circadian hormone profiles that can then be analyzed computationally to identify abnormal patterns over time.

In a proof-of-concept study, 60 patients from Bristol, Bergen, Stockholm, and Athens were monitored over a single 24-hour period. Researchers tracked aldosterone together with the related steroids 18-hydroxycortisol and 18-oxocortisol. Rather than remaining persistently elevated, hormone levels showed repeated nocturnal bursts and daytime surges.

These fluctuations may help explain why single-time-point blood tests can miss cases and were most pronounced when disease involved only one adrenal gland. In patients with unilateral disease, the abnormal hormone pattern disappeared after surgical removal of the affected gland, supporting a direct link between the rhythm and the disorder. The findings were published in Science Translational Medicine in August 2026. The technology was adopted and further developed by the spinout company Dynamic Therapeutics in 2023.

“Primary aldosteronism is an important cause of high blood pressure and the most common cause of secondary hypertension we see in our blood pressure clinic. It could be affecting millions of people in the UK. However, due to the way hormones change during the day and the current complexity of the diagnostic process, diagnosis is often delayed or never made at all. In our study, patients were monitored at home during normal activity, and this allowed us to see how hormones changed over time in realistic settings. This approach could potentially revolutionize how we diagnose hypertension and ultimately reduce cardiovascular disease—particularly heart disease and strokes—that could have been prevented,” said Dr. Thomas Upton, clinical research fellow in automated sampling, clinical fellow at the University of Bristol and senior clinical fellow at Bristol Hospitals NHS Foundation Trust.

“By continuously monitoring hormones over 24 hours, we were able to reveal a previously hidden pattern of nocturnal hormone bursts. This gives us a much clearer understanding of the disease and could ultimately help doctors detect it earlier and treat patients more effectively. A more detailed mathematical and computational analysis of daily hormonal profiles could eventually also help uncover earlier and more subtle forms of the disease, opening new opportunities to improve outcomes for patients living with high blood pressure,” said Dr. Eder Zavala, UKRI Future Leader Fellow at the University of Manchester.

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