A recent study headed by experts at Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Hospital found that brief pulses of ultrasound administered to nerves near the kidney generated a clinically relevant reduction in blood pressure in persons whose high blood pressure did not respond to a threefold cocktail of drugs.
Can Ultrasound Reduce Drug-Resistant Blood Pressure
In a medical evaluation of the technique, known as renal denervation, morning blood pressure decreased by 8 points after two months, compared to a 3-point decline in individuals treated with sham surgery. During the treatment group’s night-time blood pressure dropped by an average of 8.3 points against 1.8 points in the sham group.
Ajay Kirtane, MD, is an interventional cardiologist at New York-Presbyterian Hospital and a professor of medicine at Columbia University’s Vagelos College of Physicians and Surgeons.”For individuals with drug-resistant high blood pressure, a fall in blood pressure of eight points continued over a longer time—is definitely going to help reduce the risk of cardiovascular attack, stroke, and other adverse cardiovascular events,” says Ajay.
“This data suggest that kidney denervation might be a valuable addition to drug therapy, particularly for individuals who struggle to manage many medications to regulate their hypertension.”
The trial’s findings, termed RADIANCE-HTN TRIO, were disclosed at the American College of Cardiology meeting on May 16 and concurrently published in The Lancet. The medication is currently in the experimental stage, has not been authorized by the FDA, and is only accessible through medical studies. The experiment will follow participants for five years to see if the blood pressure decline is sustained over time.
Approximately two-thirds of persons who use blood pressure drugs can regulate their condition. However, in certain cases, the medications do not function or are not used as prescribed. Furthermore, many people just do not want to take more drugs and are dissatisfied with their adherence to them “Kirtane comments “It is evident that we require more treatment options to assist patients in achieving blood pressure management.”
The kidney regulates blood pressure by managing the amount of water in the circulation (more water=higher pressure) and functioning as a primary signaling hub for other blood pressure-regulating systems. Renal denervation, a minimally invasive therapy, disrupts impulses from hyperactive neurons in the renal arteries using ultrasound energy.
The treatment is administered by a catheter that is put through a leg artery. Targeting these neurons in hypertension therapy is not a novel concept; numerous known drugs inhibit renal nerve activity to lower blood pressure. The absence of an appropriate control group, inconsistent assessment of participants’ blood pressure, and frequent changes in background drugs in early investigations of renal denervation rendered the data difficult to interpret.
The experts examined the efficacy and stability of a device that transmits two to three brief bursts of ultrasound to nerve fibers near the renal artery throughout this investigation. The people in the research had moderate to severe hypertension despite using three or more antihypertensive medications. For their hypertension, all of the patients were put on the same drug regimen.
“In our study, 80% of participants took their prescription exactly as prescribed,” Kirtane says. 69 individuals were medicated with renal denervation, and 67 received a sham surgery out of 136 who had high blood pressure after 4 weeks on the new regimen.
A previous study found that renal denervation was more successful than sham treatment in decreasing blood pressure in persons with less severe hypertension who have not been taking any antihypertensive drugs.” Further research would be required to discover if the same therapy is useful for other populations, such as elderly people with hypertension as well as those with chronic kidney disease,” adds Kirtane.