Surgery Involving Ultrasound Energy Found to Treat High Blood Pressure
Source: Queen Mary, University of London
Summary: According to the results of a clinical trial, an operation that targets the nerves connected to the kidney has been found to significantly reduce blood pressure in patients with hypertension.
The international clinical trial carried out from 2017 to 2018 at St Bartholomew’s Hospital in the UK by the NIHR Barts Biomedical Research Centre, 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. The results of this clinical trial led in the UK by Queen Mary University of London and Barts Health NHS Trust is that an operation that targets the nerves connected to the kidney has been found to significantly reduce blood pressure in patients with hypertension. If the findings are confirmed in more extensive clinical trials, the surgery could offer hope to patients with high blood pressure who do not respond to drugs and are at increased risk of cardiovascular diseases, including stroke and heart attack. The study findings were published in the journal The Lancet.
146 patients in the United States, France, Germany, the Netherlands, Belgium and the United Kingdom were randomized to receive either renal denervation or a ‘sham procedure’ – the surgical equivalent of a placebo. Patients also remained off blood pressure medications for two months unless specified blood pressure levels were exceeded. After 2 months, the renal denervation group experienced an 8.5 mm Hg reduction in blood pressure, which was a 6.3 mm Hg greater reduction compared with the sham group. More than 66% of subjects treated with renal denervation demonstrated a 5 mm Hg or greater reduction in blood pressure, compared with 33% in the sham group. No major adverse events were reported in either group, and the blood pressure lowering effect of renal denervation was consistent across sex and ethnicity.
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.”
More Information: Michel Azizi et al, “Endovascular ultrasound renal denervation to treat hypertension (RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomized, sham-controlled trial The Lancet. DOI: doi.org/10.1016/S0140-6736(18)31082-1