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To Cut Blood Pressure, Nerves Get a Jolt
from the New York Times (Registration Required)
In recent decades, there have been few new treatments for people with stubbornly high blood pressure. Exercise and a low-sodium diet, along with such stalwart drugs as diuretics, ACE inhibitors and beta-blockers, have made up the standard regimens. But these efforts fail in a surprising number of patients. On three or more medications, many still suffer from uncontrolled hypertension and with it a heightened risk of heart attack and stroke.
Now, doctors are experimenting with an innovative but drastic new approach that may help lessen the danger in patients for whom nothing else works. During the procedure, called renal denervation, a physician threads a catheter into the arteries leading to the kidney, then delivers pulses of radio-frequency energy that interrupt the signaling in nerves to and from that organ. The damage to the nerves is probably permanent, although no one is certain.
Small clinical trials, conducted mainly outside the United States, have suggested that in combination with drugs, renal denervation may help to reduce high blood pressure in patients with so-called treatment-resistant disease. The treatment is already available in Australia and Europe.