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An operation that targets the nerves connected to the kidney has been found to significantly reduce blood pressure in patients with hypertension, according to the results of a clinical trial led in the UK by Queen Mary University of London and Barts Health NHS Trust, and supported by the National Institute for Health Research (NIHR).
The results are published in The Lancet and have been presented at the EuroPCR congress in Paris.
If the findings are confirmed in more extensive clinical trials, the surgery could offer hope to patients with high blood pressure who do not respond to drugs, and are at increased risk of cardiovascular diseases, including stroke and heart attack.
The international clinical trial, carried out from 2017 to 2018 at St Bartholomew's Hospital in the UK by the NIHR Barts Biomedical Research Centre, tested a one-hour operation called 'renal denervation', which uses ultrasound energy to disrupt the nerves between the kidneys and the brain that carry signals for controlling blood pressure.
146 patients in the United States, France, Germany, the Netherlands, Belgium and the United Kingdom were randomised to receive either renal denervation or a 'sham procedure' -- the surgical equivalent of a placebo. Patients also remained off blood pressure medications for two months unless specified blood pressure levels were exceeded.
After two months, the renal denervation group experienced an 8.5 mm Hg reduction in blood pressure, which was a 6.3 mm Hg greater reduction compared with the sham group. More than 66 per cent of subjects treated with renal denervation demonstrated a 5 mm Hg or greater reduction in blood pressure, compared with 33 per cent in the sham group.
[...] The study has limitations including the short follow-up time of two months. This was done for safety reasons to minimise the duration of patients being off antihypertensive medications. Longer follow-up of this trial and additional numbers of treated patients will be necessary to provide greater assurance of safety and to exclude rare adverse events.
(Score: 4, Informative) by frojack on Friday May 25 2018, @07:05PM (3 children)
I was wondering the same thing.
A 8.5 mm Hg is a very small reduction to achieve for destruction of a nerve. Especially when a sham causes 2.2 mm hg drop. Many people can achieve a drop of 10 mmhg with simple relaxation techniques, and two readings by the same technician within a 5 minute period are likely to vary by 10 points. (If your doctor has ONE reading taken upon each visit, they are doing it wrong. [heart.org]
So 8.5 mm Hg seems rather modest. Especially when proven safe inexpensive medications generally target 40 to 80 mmhg reductions and are highly dosage responsive, meaning they are reliably fine tune-able.
TFS claims these patients "do not respond to drugs" yet they had to keep them off drugs while they were involved in the study, and their bail-out plan included resuming drug treatment. So which is it, Drugs don't work, or Drugs do work?
No, you are mistaken. I've always had this sig.
(Score: 0) by Anonymous Coward on Friday May 25 2018, @11:46PM (2 children)
While an 8.5mmHg reduction is rather modest, it is still significant nonetheless. Also, I would point out that this appears to be the first of clinical trials. Hopefully, as they improve their technique the reductions in BP will be more significant. Also, where are you getting this idea of 40 to 80 mmHg reductions? While that is possible with medication, the dosages to achieve those numbers are almost always very high. If I understand the medical literature on the subject, getting a 40 to 80 mmHg reduction in BP typically requires two or more different BP medications. And, these medications have side effects, some of which are really nasty. If you doubt me, google the various classes of BP medication and find out what kinds of side effects you need to look out for. Besides that, the vast majority of people put on BP medication will never get off of it; the patient is hooked on BP medication for life. I know whereof I speak; right now my numbers are mid-to-high 130s (systolic) over mid-to-high 80s (diastolic) and my doctor is urging me to try BP medication, something I am not too keen on. I will be very interested to see how this new therapy gets developed and refined over the next several years, especially if it is proven safe, effective, and keeps the pharmacist away.
(Score: 0) by Anonymous Coward on Saturday May 26 2018, @12:05AM
That's crazy, its normal ambulatory blood pressure and only slightly high resting blood pressure. Just stop drinking booze and smoking, exercise a bit (just walk/run/jog a few miles a day, takes 1-2 hrs), and learn diaphragmatic breathing (this will also help you exercise longer). You can lower your BP ~10 mmHG in like 3 days with that. You can get an automatic bp monitor from walgreens for like 50 bucks to see for yourself.
Of course as soon as you drink, etc again it will pop back up...
(Score: 2) by sjames on Saturday May 26 2018, @01:39AM
To put it in perspective for you, how would you feel about surgery? I ask, because if and only if you were among the strong responders you would be just at the threshold of BP meds being recommended anyway.