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High blood pressure? Try an operation which hot-wires your kidneys

January 16, 2012
By

By
Roger Dobson

Last updated at 10:29 PM on 14th January 2012


Patient Anthony Henry

Patient Anthony Henry

An operation that ‘hot-wires’ the kidneys could be the key to reducing high blood pressure in hard-to-treat patients.

Twenty UK patients with high blood pressure (hypertension) who had not responded to drugs have been helped by the minimally invasive technique.

A tiny wire is used to burn a nerve in the kidneys. Six months after treatment, four out of ten patients had reached their recommended blood-pressure level.

‘Based on the evidence so far, this is an important development in hypertension therapy,’ says Dr Mel Lobo, consultant and clinical hypertension specialist at Bart’s the London NHS Trust.

Thirty per cent of UK adults have high blood pressure. For more than 90 per cent, the cause is unknown, although age, family history, weight, high salt intake and stress can increase the risk.  Less than five per cent of cases are the result of underlying conditions, such as adrenal gland disorders.

Left untreated, high blood pressure can lead to heart attack, stroke and kidney failure. Although a number of drugs are used to treat the condition, it is estimated that among those diagnosed, up to 50 per cent of hypertensive patients do not have their blood pressure under control.

The new treatment is based on destroying part of the nervous system in the kidneys to stop messages travelling between them and the brain.

In the 40-minute procedure, under local anaesthetic, a catheter is inserted into the femoral artery in the groin and navigated with the help of a guide wire to the kidneys.

Once it is in place, a radio-frequency generator is used to warm up a wire inside the catheter. The targeted nerves are located in the outer wall around the outside of arteries that supply blood to the kidneys. The heat is used to destroy the nerves around the circumference of the artery. Results so far on patients with drug-resistant hypertension show that the operation can be highly effective. Patients still need medication, but their blood pressure is brought down and under control. In one trial,  39 per cent reached the recommended blood pressure level and 85 per cent responded.

‘I feel much better and I can go on long walks I couldn’t do before.

‘It was a risk to have a new operation, but I hope that many more people can be helped.’

Exactly how it works is not clear, but the nervous system has a key role in blood-pressure regulation. Before drugs such as beta-blockers, high blood pressure was treated with invasive surgical sympath-ectomy, where nerves were cut. It reduced blood pressure in half of patients, but it required two weeks in hospital, with months of convalescence. Many patients died, and it was abandoned in the Sixties.

One theory is that high blood pressure is due to faulty signals travelling between the brain and the kidneys along the renal nerves, and those with treatment-resistant blood pressure have been shown to have higher levels of this nervous system activity.

The first UK patient to benefit was Anthony Henry, 69, a retired chef and father of three who lives with his wife Gloria in London. He was diagnosed with high blood pressure ten years ago after a stroke.

He says: ‘I was on more and more tablets until I was on the maximum dose, but my blood pressure was not under control. I feared I would have a heart attack or another stroke.’

He was referred for the trial treatment last summer. ‘My blood pressure started to improve three weeks later and kept on improving.

‘The number of drugs I take has been reduced, and my blood pressure is under control.

‘I feel much better and I can go on long walks I couldn’t do before.

‘It was a risk to have a new operation, but I hope that many more people can be helped.’

 

Article source: http://www.dailymail.co.uk/health/article-2086665/High-blood-pressure-Try-operation-hot-wires-kidneys.html?ITO=1490

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