In a nutshell
This paper studied whether renal denervation plus antihypertensive treatment is more effective than antihypertensive treatment alone.
Some background
Endovascular renal denervation with radiofrequency ablation is a procedure where radiofrequency is used to destroy nerves to the kidney. This procedure is used in the treatment of resistant hypertension (high blood pressure not controlled by 3 treatments). Further studies on the safety and effectiveness of this procedure are needed.
Methods & findings
The authors conducted a trial which studied whether adding a renal denervation to standard hypertension treatment is more effective than hypertension treatment alone. 44 patients received renal denervation and antihypertensive treatment while 53 patients received only antihypertensive treatment. All patients received spironolactone (Aldactone), bisoprolol (Zebeta), prazosin (minipress), and rilmenidine (Albarel) per day if their blood pressure was more than or equal to 135/85 mmHg as part of antihypertensive treatment. The change in blood pressure over 6 months was measured.
The change in average daytime blood pressure after 6 months was significantly greater among patients who received renal denervation than patients who did not. 41.7% of patients receiving renal denervation had a 20 mmHg or more decrease in daytime blood pressure, compared to 20.8% of patients who did not receive renal denervation.
Among patients receiving renal denervation, 41.7% had controlled daytime blood pressure, 31.3% had controlled night-time blood pressure and 39.6% had controlled 24-hour blood pressure. Among patients who did not receive renal denervation, 28.3% had controlled daytime blood pressure, 11.3% had controlled night-time blood pressure and 18.9% had controlled 24-hour blood pressure.
The authors also studied adverse events (undesired effect of treatment). Among patients receiving renal denervation, two had lower back pain while one patient had mild groin hematoma (collection of blood in groin area). Overall, there was a low occurrence of adverse events.
The bottom line
The authors concluded that in patients with resistant hypertension, renal denervation plus antihypertensive treatment decreases blood pressure more than antihypertensive treatment alone at 6 months.
The fine print
This was a short term study, longer term studies are needed.
What’s next?
Talk to your doctor about receiving a renal denervation procedure.
Published By :
The Lancet
Date :
Jan 23, 2015
