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Ultrasound surgery may offer new treatment for hypertension

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An operation that targets the nerves connected to the kidney has been found to significantly reduce blood pressure in patients with hypertension, according to a clinical trial involving UK researchers.

If the findings are confirmed in more extensive trials, it could offer hope to those with high blood pressure who do not respond to drugs and are at increased cardiovascular risk, said those behind it.

“These results leave us clinicians in no doubt that this ultrasound-based therapy works”

Melvin Lobo

The international trial was led in the UK by Queen Mary University of London and Barts Health NHS Trust, with support from the National Institute for Health Research (NIHR).

Researchers tested a one-hour operation called renal denervation, which uses ultrasound energy to disrupt the nerves between the kidneys and the brain that carry signals for controlling blood pressure.

In total, 146 patients in the US, France, Germany, the Netherlands, Belgium and the UK were randomised to receive either renal denervation or a sham procedure to act as a control.

Patients also remained off blood pressure medications for two months unless specified blood pressure levels were exceeded.

After two months, the renal denervation group experienced an 8.5mmHg reduction in blood pressure, which was a 6.3mmHg greater reduction compared with the sham group.

More than 66% of subjects treated with renal denervation demonstrated a 5mmHg or greater reduction in blood pressure, compared with 33% in the sham group, said the study authors.

The noted that no major adverse events were reported in either group, and the blood pressure lowering effect of renal denervation was consistent across sex and ethnicity.

Renal denervation system

Ultrasound surgery may offer new treatment for hypertension

Renal denervation system

UK principal investigator Dr Melvin Lobo said: “These results leave us clinicians in no doubt that this ultrasound-based therapy works to improve blood pressure control – at least in the short term.

“Further larger trials will be needed to confirm the efficacy and safety of the technology, but we hope that they could lead to renal denervation therapy being offered as an alternative to lifelong medications for hypertension,” he said.

The researchers noted that the study had limitations including the short follow-up time of two months, but said this was done to minimise the duration of patients being off anti-hypertensives.

Longer follow-up of this trial and additional numbers of treated patients will be necessary to provide greater assurance of safety and to exclude rare adverse events, they said.

The study was funded by ReCor Medical, which manufactures the Paradise Renal Denervation System, which was used in the trial. The results have been published in The Lancet and presented at the EuroPCR congress in Paris.

Renal denervation system

Ultrasound surgery may offer new treatment for hypertension

Renal denervation system

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