Wednesday, November 17, 2010

Operation to 'cure' high blood pressure could benefits thousands

A one-hour operation to "cure" high blood pressure could benefit tens of thousands of patients in Britain after a global study found it was safe and effective.

Patients undergoing the procedure saw their blood pressure drop by around 20 per cent – enough to halve their risk of dying from a heart attack or stroke.

The procedure severed the nerves connecting the kidneys to the brain which carry signals to control blood pressure. In some patients, blood pressure remains high despite being on a cocktail of drugs.

For these patients and those unable to take blood pressure medication, the procedure could offer hope to bring their condition under control.

The results of a trial involving 52 patients who were given the procedure compared with those who remained on their normal medication were published in The Lancet medical journal and presented at the American Heart Association meeting.

Experts said the findings were exciting and because there were no major side effects, it is hoped the procedure can be rolled out soon.

There are around 16m people with high blood pressure in Britain, half of whom have not been diagnosed.

The procedure, called renal sympathetic-nerve ablation, takes around one hour and involves threading a wire along a patient's vein into the main blood vessels feeding the kidney where the tip of the wire is heated to burn the nerves running along the outside of the vessel.

The tiny burns are done in a spiral pattern around the blood vessels until the connections are severed.

On average the patients who received the procedure saw their systolic blood pressure, expressed as the first of two numbers, from 178 to 146 and this was sustained over six months. The target systolic pressure is 130mm of mercury. ...

High blood pressure is diagnosed as consistent readings at or above 140/90mmHg and healthy blood pressure is less than 120/80mmHg.

More than eight in ten of those who had the procedure saw their systolic blood pressure drop by at least 10mmHG.

The patient does not need a general anaesthetic and in most cases will be allowed home the same day. ...

via Operation to 'cure' high blood pressure could benefits thousands - Telegraph.

Catheter-based radiofrequency renal sympathetic denervation dropped blood pressure by 27/17 mm Hg at one year in patients initially at 160 mm Hg or higher despite treatment with at least three antihypertensives, Henry Krum, Ph.D., of Monash University in Melbourne, Australia, and colleagues found.

No serious ablation-related adverse events or alterations in renal function accompanied these impressive benefits, the researchers reported at the American College of Cardiology meeting ...

Although the short-term safety results were generally called reassuring, Dr. Jones sounded a note of caution about long-term consequences for the renal artery. The FDA will likely want to see two- to five-year safety data, but there is some potential for effects to show up as late as 15 to 20 years out, he said.

But long-term consequences of knocking out the renal sympathetic nerve are unlikely, Dr. Jones noted. "We've had a good long-term look at the effect among kidney transplant patients, in whom the vascular system is reattached but the renal nerves are not." ...

via MedPageToday

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