In a nutshell
This study looked at the use of renal denervation in patients with true resistant hypertension. It found that this procedure reduced blood pressure compared to medicine alone.
High blood pressure (BP) which is not controlled on three blood pressure-lowering medications including a diuretic (water pill) is called resistant hypertension. These patients need alternative treatments as persistent high BP increases the risk for stroke, heart attack, or death.
Renal ultrasound denervation (RUDN) is a treatment used for resistant hypertension. It involves using ultrasound waves to damage (burn) the nerves in the kidney blood vessels, leading to lower BP. It is not clear if RUDN is effective in patients with true resistant hypertension.
Methods & findings
136 patients with true resistant hypertension participated in this study. To test for true resistant hypertension, patients were switched from their 3 medications to a single fixed combination pill that contained all three medications they were taking. If their BP was still high after 4 weeks, they were considered to have true resistant hypertension and were included in the study. Patients were divided into two groups. Group 1 (69 patients) underwent RUDN treatment using the Paradise System. Group 2 (67 patients) underwent a fake procedure. All patients were given standard medical treatment as well.
After 2 months, the average systolic BP (BP when the heart beats) in the RUDN group was 4.5 mmHg lower than in the fake procedure group. 24 hours BP at home was also 4.2 mmHg lower in group 1 compared to group 2.
Kidney function was similar in both groups after 2 months.
The bottom line
This study showed that RUDN is an effective treatment for patients with resistant hypertension in combination with medical treatment.
The fine print
This study followed patients for 2 months only. Longer studies are needed to see if the effects of RUDN last in the long term. This study was funded by ReCor Medical, the manufacturer of the Paradise System for RUDN.
Published By :
Lancet (London, England)
May 14, 2021