Is renal artery denervation surgery a good option for patients with resistant hypertension?

This study looked at the use of renal denervation surgery (RDS) in patients with resistant hypertension. They found that after 12 months RDS led to a significant drop in blood pressure in these patients.

Resistant hypertension is high blood pressure that is not controlled despite using at least 3 different blood pressure medications. RDS involves using high-frequency energy to damage the nerves of the renal (kidney) artery. It is a treatment option for patients who have resistant hypertension. It is known that RDS helps to lower blood pressure. However, most of the studies involving RDS included patients without significant medical conditions. Therefore, it is not clear if this procedure is safe and effective in a real-world setting in patients who may have other health problems.

This study involved 40 patients with resistant hypertension and other health problems. They were treated with RDS. Blood pressure was measured over a 24 hour period (ambulatory blood pressure), first before the RDS, then at 3, 6, and 12 months after the procedure. Office blood pressure was also measured at the same time points.

After 3 months, office blood pressure decreased by 8.5/1.5 mmHg on average. After 12 months, office blood pressure decreased by 19.7/3.8 mmHg on average. 39% of patients achieved a target blood pressure of below 140 mmHg after 3 months and 44% after 12 months.

Ambulatory blood pressure decreased, on average, by 9.7/4.2 mmHg after 3 months and by 13.9/6.1 mmHg after 12 months. After 12 months, 39% of patients achieved the target ambulatory blood pressure.  

None of the patients experienced major complications to the procedure. 4 patients experienced a short-term decrease in kidney function that normalized after hydrating. 

This study showed that RDS is a safe and effective treatment for patients with resistant hypertension and other health problems. 

This is a relatively small study, involving only 40 patients. Further studies are needed to confirm these findings.