Renal Denervation: A New Hope for Managing Resistant High Blood Pressure
A cutting-edge treatment targeting overactive kidney nerves is offering relief for patients with treatment-resistant hypertension.
High blood pressure, or hypertension, is a silent yet serious health issue affecting nearly half of U.S. adults. For many, lifestyle changes and medications can help control blood pressure, but some cases prove resistant to treatment. Enter renal denervation, a newly FDA-approved procedure that disrupts overactive nerves in the kidneys, showing promise for individuals who’ve struggled to lower their blood pressure despite medical intervention.
A New Approach to Hypertension Treatment
Michael Garrity, a 62-year-old from Needham, Massachusetts, had been battling severe hypertension for decades. Despite taking up to six medications and adhering to a strict diet and exercise regimen, his blood pressure frequently spiked to dangerous levels. That changed after undergoing renal denervation, a minimally invasive procedure that targets the renal nerves.
“My blood pressure would spike, and I’d run out of breath and feel tired. That doesn’t happen anymore,” Garrity said. Now, his blood pressure is stable for the first time in years, and he’s able to reduce his medication dosage. “I’m thrilled,” he added.
Understanding High Blood Pressure
Blood pressure is measured in two numbers:
Systolic pressure: The force blood exerts on artery walls as the heart pumps.
Diastolic pressure: The pressure between heartbeats.
Normal blood pressure is below 120/80 mmHg. When it consistently measures 130/80 or higher, it increases the risk of serious conditions like heart attacks, strokes, kidney failure, and even dementia.
How Renal Denervation Works
Renal denervation involves threading a catheter through blood vessels to the kidneys and using ultrasound or radiofrequency energy to deactivate specific nerves. These overactive nerves contribute to the body’s inability to regulate blood pressure.
The outpatient procedure, which takes about an hour, has been shown to reduce systolic blood pressure by an average of 8 to 10 points. While not a cure, some patients, like Garrity, experience significant improvements that allow for reduced medication use.
Dr. Joseph Garasic, an interventional cardiologist at Massachusetts General Hospital, explained, “It’s a modest but meaningful improvement, particularly for those with treatment-resistant hypertension.”
Who Are Good Candidates?
The FDA approved renal denervation in late 2023 after years of testing and refinement. It’s considered safe for carefully selected patients whose blood pressure remains high despite medication. However, it’s not recommended for individuals with kidney disease, narrowed arteries, or certain other conditions.
The procedure is still in its early stages in the U.S., and guidance from the American Heart Association emphasizes the importance of informed discussions between patients and experienced doctors to determine suitability.
Challenges and Considerations
Renal denervation isn’t without its limitations:
The nerves may regenerate over time, and long-term studies are ongoing.
Not all patients experience significant benefits.
The procedure, costing several thousand dollars, may not yet be covered by insurance.
Importance of Blood Pressure Awareness
“Know your blood pressure, know the numbers,” urged Dr. Randy Zusman of Massachusetts General Hospital. He recommends yearly blood pressure checks, even for those who feel healthy, as hypertension often goes unnoticed until significant damage occurs.
Measuring blood pressure at home or at local pharmacies is convenient, but accuracy is critical. The American Medical Association advises:
Sit quietly with your feet flat on the floor.
Use a cuff on a bare arm, resting it on a table.
Avoid crossing your legs or dangling your arm.
Beyond Medication: Lifestyle Changes
For many, lifestyle modifications can significantly lower blood pressure:
Maintain a healthy weight.
Exercise regularly.
Eat a balanced diet rich in fruits and vegetables while reducing salt and alcohol intake.
Manage stress effectively.
A Promising Future
Renal denervation is a beacon of hope for those with resistant hypertension, offering a new path to control blood pressure and reduce the risk of life-threatening complications. As research continues and insurance coverage evolves, this innovative procedure may become a vital tool in combating a leading global health challenge.
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