” Many patients in our scientific practice are simply like the patients in our research study, with uncontrolled blood pressure in the 150s despite some efforts,” states Ajay Kirtane, MD, professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and co-leader of the study.
Leaving high blood pressure uncontrolled for too long can cause cardiac arrest, strokes, heart attacks, and irreparable kidney damage.
” Renal ultrasound could be used to patients who are not able to get their blood pressure under control after attempting way of life changes and drug treatment, prior to these events happen,” states Kirtane, who is also an interventional cardiologist and director of heart catheterization labs at NewYork-Presbyterian/Columbia University Irving Medical Center.
The results of the research study, published in JAMA Cardiology, checked the gadget, which is utilized in an outpatient procedure called ultrasound kidney denervation. The device is still investigational and has actually not yet been authorized by the FDA for usage beyond scientific trials.
Kidney nerves and high blood pressure.
High blood pressure in middle age is believed to be triggered in part by overactive nerves in the kidneys, which activate water and salt retention and release hormones that can raise blood pressure. (In older people, hypertension typically happens as blood vessels stiffen). Antihypertensive drugs work in different methods to lower blood pressure, by dilating blood vessels, getting rid of excess fluid, or blocking hormones that raise high blood pressure. None of these medications target the renal nerves directly.
Ultrasound therapy calms overactive nerves in the renal artery, disrupting signals that lead to high blood pressure. The treatment is provided to the nerves via a thin catheter that is placed into a vein in the leg or wrist and threaded to the kidney.
Research study outcomes
The brand-new study pooled information from 3 randomized trials incorporating more than 500 middle-aged patients with varying degrees of hypertension and medication usage.
Two times as numerous patients who got the ultrasound treatment reached their target daytime high blood pressure (less than 135/85 mmHg) compared to clients in the sham groups.
” The outcome was practically identical across the different study hall, which definitively reveals that the device can lower blood pressure in a broad series of patients,” Kirtane says.
The procedure was well-tolerated, and the majority of clients were discharged from the healthcare facility the same day. According to Kirtane, enhancements in blood pressure were seen as soon as one month after the treatment.
The treatment will be evaluated by the FDA in the coming months.
Bottom line for patients with resistant hypertension
The investigators expect the treatment might be used as an adjunct to medication treatment and lifestyle modifications for patients with unchecked high blood pressure.
” Once the device is available, we visualize advising it to clients who have actually attempted other treatments. The hope is that by controlling blood pressure, we might be able to prevent kidney damage and other impacts of uncontrolled high blood pressure,” Kirtane includes.
Referral: “Patient-Level Pooled Analysis of Ultrasound Renal Denervation in the Sham-Controlled RADIANCE II, RADIANCE-HTN SOLO, and RADIANCE-HTN TRIO Trials” by Ajay J. Kirtane, MD, SM, Andrew S. P. Sharp, MD, Felix Mahfoud, MD, MA, Naomi D. L. Fisher, MD, Roland E. Schmieder, MD, Joost Daemen, MD, Ph.D., Melvin D. Lobo, Ph.D., Philipp Lurz, MD, Ph.D., Jan Basile, MD, Michael J. Bloch, MD, Michael A. Weber, MD, Manish Saxena, MBBS, MSc, Yale Wang, MD, Kintur Sanghvi, MD, J. Stephen Jenkins, MD, Chandan Devireddy, MD, Florian Rader, MD, MSc, Philippe Gosse, MD, Marc Sapoval, MD, Neil C. Barman, MD, Lisa Claude, MS, Dimitri Augustin, MD, Lisa Thackeray, MS, Christopher M. Mullin, MS and Michel Azizi, MD, Ph.D. for the RADIANCE Investigators and Collaborators, 28 February 2023, JAMA Cardiology.DOI: 10.1001/ jamacardio.2023.0338.
The research study was funded by ReCor Medical.
The study includes information from the RADIANCE II trial, which was released concurrently in JAMA and was likewise co-led by Kirtane.
High blood pressure, likewise known as hypertension, is a medical condition where the pressure of the blood in the arteries is persistently elevated. This can result in severe health issues such as heart illness, stroke, and kidney failure if left without treatment.
An ultrasound gadget that relaxes overactive nerves in the kidneys has the prospective to assist some individuals get their high blood pressure under control.
According to a new research study carried out by researchers at Columbia University and the Université de Paris in France, making use of the device resulted in a constant decrease of daytime ambulatory blood pressure by an average of 8.5 points among middle-aged people with hypertension
Medical professionals normally prescribe lifestyle modifications, such as reducing salt consumption or losing weight, and medications to lower blood pressure in patients with high blood pressure. Yet about one-third of hypertensive patients are not able to control their high blood pressure regardless of these interventions.
