The latest research shows that renal denervation may be an effective treatment for resistant hypertension

Hypertension-Hypertension-affects nearly half of American adults, increasing their risk of stroke, ischemic heart disease, kidney disease, and peripheral arterial disease.

Treatment usually includes medication and lifestyle changes. However, for some people, due to various factors, proper management is more challenging. This puts them at a higher risk of cardiovascular and renal complications.

Many of these people have drug-resistant hypertension-although the three antihypertensive drugs are used at the optimal doses, their blood pressure rises. The disease affects about 30% of American adults with high blood pressure.

The most common way for physicians to treat resistant hypertension is to increase their search for more effective drugs and dosage combinations, while also addressing other potential influencing factors-persistent unhealthy lifestyles, stress, and obstructive sleep apnea.

Excessive intake of salt and alcohol and failure to take medications will also reduce Experts say the effectiveness of antihypertensive drugs.

But new research There is some hope that renal denervation, which has long been considered an experimental treatment, may indeed be an effective solution for drug-resistant hypertension.

experimental method

Since the 1990s, renal denervation has been considered a possible treatment for resistant hypertension, but it is still in the experimental stage due to the mixed results of clinical trials.

some studies Recommendations can significantly reduce blood pressure.Others, such as a controlled trial in 2014, Found that there was no significant difference in blood pressure reduction between people who underwent renal denervation and people who underwent mimic surgery. But critics pointed out some limitations related to this research method.

The sympathetic nervous system prepares people for stress by increasing heart rate and blood flow to the muscles, but excessive activity of these nerves in the kidneys can also cause blood pressure to rise.

Kidney denervation is the process of transferring energy to overactive nerves to reduce energy A sympathy signal sent between the kidney and the brain. The process involves the delivery of low-power radiofrequency energy through a catheter to the wall of the renal artery.

nothing now Radiofrequency ablation Equipment has been acquired U.S. Food and Drug Administration Ablation of renal sympathetic nerves is used as a treatment for hypertension. However, several devices are in trial, including Medtronic’s Symplicity renal denervation system.

This Latest research, Published in The Lancet, involving 989 patients from the United States, the United Kingdom and five European countries. It provides a new optimistic view that renal innervation may be an effective way to treat uncontrolled hypertension.

At the time of enrollment in the study, patients had an average blood pressure of 163/104 mmHg-blood pressure higher than 130/80 mmHG was considered hypertension. Despite the average use of four antihypertensive drugs, these high numbers persist.

In patients undergoing renal innervation, the median ambulatory systolic blood pressure during the day two months after the operation decreased by 8 mmHg.

Their blood pressure drop was also 4.5 mmHg higher than that of patients undergoing generic surgery. Both groups received the same three antihypertensive drugs during the study.

This study shows for the first time that renal innervation can effectively treat patients with refractory hypertension who do not respond to standardized treatments. Say Dr. Ajay Kirtane, an interventional cardiologist at the New York Presbyterian Church/Columbia University Irvine Medical Center.

“[It] Provides other tools that we can use to help these patients, hoping to better control hypertension in a comprehensive way, especially if long-term data supports the durability and safety of surgery. “

Three drugs are taken in one dose. During the two months of follow-up, the patients’ urine was tested to assess their adherence to contraceptive pills.

Researchers also reported adverse events, including death from any cause, kidney failure, blood clots, or any venous or arterial complications after surgery. There were no reports of significant differences in major adverse events between the two groups.

The research was funded by Recor Medical Inc., a manufacturer of the heavenly kidney denervation system. Researchers will continue to study patients for up to three years.

Other ways to fight high blood pressure

Johns Hopkins University The doctor said that if high blood pressure cannot be controlled even with treatment, the patient should discuss possible influencing factors with the doctor. In addition to finding the right dosage and the right combination of drugs and treating other diseases, they should also exclude other drugs or supplements as the culprit.

Congestion pills, birth control pills and antidepressants can all cause a person’s blood pressure to rise. Caffeine, cigarettes, attention deficit hyperactivity disorder drugs and people who lack exercise can also do it. Studies have shown that only 40 minutes of aerobic exercise four times a week may be as effective as certain drugs in reducing high blood pressure.

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