In a nutshell
This study investigated the effect of using ultrasound renal denervation to treat hypertension. They concluded that ultrasound renal denervation improved blood pressure control in patients with moderate hypertension.
Some background
The kidneys play an important role in blood pressure control. There are nerves located in the renal (kidney) vessels that can sense blood pressure levels. These nerves send electrical signals to the kidney to reduce or increase the volume of blood in the vessel. This causes an increase (or decrease) in blood pressure.
Some patients do not respond well to blood pressure-lowering medications. This is known as resistant hypertension. Renal denervation may be useful to reduce blood pressure in these patients. Renal denervation is a procedure to destroy renal nerves, which may also reduce blood pressure. Ultrasound waves can be used to kill renal nerves without damaging other tissue.The effect of ultrasound renal denervation on hypertension is still under investigation.
Methods & findings
This study investigated the effects of ultrasound renal denervation on blood pressure in patients with moderate hypertension.
This study included 146 patients with hypertension. All patients stopped taking medication to treat hypertension for 4 weeks prior to the study and then underwent a renal angiogram (a way to image the blood vessels in the kidney). Patients assigned to renal denervation underwent the procedure immediately after the angiogram. Patients in the ‘sham’ (control) group did not undergo any other procedure. Patients were evaluated before the procedure and at 1 and 2 months later. Patients also measured their blood pressure (BP) twice daily for 7 days before each clinic visit.
66% of patients in the renal denervation group had a BP reduction of at least 5 mmHg, compared to 33% in the sham group. More patients in the sham group required medication to treat hypertension over the course of the study (79% versus 55% in the renal denervation group). 22% of renal denervation patients had controlled ambulatory (moving) BP compared to 3% of sham patients. No major adverse events were observed at any clinic visits. An even greater improvement in BP was observed in patients with abdominal obesity following renal denervation.
The bottom line
The authors concluded that ultrasound renal denervation improved blood pressure control in patients with moderate hypertension.
The fine print
A long-term study is needed to determine the safety and effectiveness of ultrasound renal denervation.
Published By :
Lancet (London, England)
Date :
May 22, 2018
