Milan, Italy – A new approach to controlling blood pressure without drugs was discussed here at the Milan conference on hypertension as a potential simple, brief adjunct or even alternative – to conventional pharmacological therapy.
Murray Esler, MD PhD, from the Baker IDI Heart & Diabetes Institute in Melbourne, Australia, delivered his team’s latest data from the study – recently published in The Lancet (Lancet 2009 Apr 11;373(9671):1275-81. Epub 2009 Mar 28) – which used a catheter-delivered nerve ablation technique to control renal sympathetic hyperactivity to reduce blood pressure.
The study has investigated 61 patients so far who had systolic blood pressures of at least 160 mmHg despite being treated with three or more antihypertensive medications. Reduction of systolic pressure by a median of 27 mmHg in this group was achieved which has been sustained out to 12 months.
The technique aims to disrupt the renal sympathetic nerve-adjacent to the main renal artery-by irradiation with pulses of radio frequency energy in order to alter sympathetic activity modulated by the brain. Dr Esler pointed out that the percutansious procedure takes less than an hour, is easily done by interventionists and was found to be safe, with no incidents of renal artery stenosis.
The investigators think that the efficacy of the procedure in patients with refractory hypertension, and the magnitude of its effect suggests that methods based on this approach might translate into more routine use in the clinic-not only for refractory and severe hypertension but also for more moderately raised blood pressure. In Milan Dr Esler speculated that there is a possibility that this could be used for most – perhaps all -patients with hypertension, reducing the need for drugs or avoiding them altogether.