Magic bullet for high blood pressure

A ONCE-OFF surgical procedure which dramatically reduces high blood pressure is being hailed by experts as a “magic bullet” for cardiovascular disease.

Australian-led research which found the treatment to be highly effective in the hardest to treat of patients will be presented at a US conference today, and also published in The Lancet.

Melbourne’s Baker IDI Heart and Diabetes Institute led the international trial, which found “renal denervation” caused a major drop in blood pressure for patients not responding to existing anti-hypertensive drugs.

These patients were otherwise “waiting for their strokes to happen”, said Professor Markus Schlaich, and the new procedure should “hopefully control their blood pressure of the rest of their life”.  “It’s very thrilling and extremely promising,” Prof Schlaich said of the new frontier in cardiovascular disease treatment.

“There are so many patients where we can’t control their blood pressure despite all the good drugs we have, and they are really waiting for their strokes to happen. “This procedure really offers the potential to do a one-off treatment, which may not always normalise their blood pressure but it will definitely reduce it.”

A person’s blood pressure should not be higher than 140mmHg (read as millimetres of mercury), and easing high blood pressure by just 5mmHg was known to cut the risk of stroke by almost 30 per cent.

Renal denervation – performed via a catheter inserted into a patient’s groin – was found to reduce blood pressure in the hardest-to-treat patients by 10mmHg to 33mmHg.

The procedure involves sending a tiny probe into an artery near the kidney, where pulses of energy were used to desensitise some of the renal sympathetic nerves which regulate blood pressure.

This resulted in a lasting drop in blood pressure – and a patient’s lifetime risk of heart attack and stroke. Prof Schlaich said the same technique had “enormous potential” for use in survivors of heart attack and people with other chronic diseases. “Because, if we can selectively and directly reduce the activity of these nerves, which appear to play such a crucial role, we really appear to have a magic bullet,” Prof Schlaich said.

Up to 30 per cent of the Australian population is thought to have high blood pressure and the conventional treatment is lifestyle change, weight loss – and anti-hypertensive drugs. For many of these patients, not even these interventions return their blood pressure to within a healthy range.

Renal denervation could be performed routinely in hospitals within a year, as a necessary device has already been approved by Australia’s Therapeutic Goods Administration. The trial involved more than 100 patients in Europe and Australia, and 84 per cent of patients showed a sustained blood pressure drop of more than 10mmHg without side-effects.

These results will be presented at the American Heart Association’s conference, in Chicago, by Baker IDI’s Professor Murray Esler.

It was a “truly revolutionary treatment” for the “large number of patients suffering from uncontrolled blood pressure”, Prof Esler said.

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