High blood pressure? Try an operation which hot-wires your kidneys

(Daily Mail) — An operation that ‘hot-wires’ the kidneys could be the key to reducing high blood pressure in hard-to-treat patients.

Twenty UK patients with high blood pressure (hypertension) who had not responded to drugs have been helped by the minimally invasive technique.

A tiny wire is used to burn a nerve in the kidneys. Six months after treatment, four out of ten patients had reached their recommended blood-pressure level.

‘Based on the evidence so far, this is an important development in hypertension therapy,’ says Dr Mel Lobo, consultant and clinical hypertension specialist at Bart’s & the London NHS Trust.

Thirty per cent of UK adults have high blood pressure. For more than 90 per cent, the cause is unknown, although age, family history, weight, high salt intake and stress can increase the risk.  Less than five per cent of cases are the result of underlying conditions, such as adrenal gland disorders.

Left untreated, high blood pressure can lead to heart attack, stroke and kidney failure. Although a number of drugs are used to treat the condition, it is estimated that among those diagnosed, up to 50 per cent of hypertensive patients do not have their blood pressure under control.

The new treatment is based on destroying part of the nervous system in the kidneys to stop messages travelling between them and the brain.

In the 40-minute procedure, under local anaesthetic, a catheter is inserted into the femoral artery in the groin and navigated with the help of a guide wire to the kidneys.

Once it is in place, a radio-frequency generator is used to warm up a wire inside the catheter. The targeted nerves are located in the outer wall around the outside of arteries that supply blood to the kidneys. The heat is used to destroy the nerves around the circumference of the artery. Results so far on patients with drug-resistant hypertension show that the operation can be highly effective. Patients still need medication, but their blood pressure is brought down and under control. In one trial,  39 per cent reached the recommended blood pressure level and 85 per cent responded.

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