New treatment could change hypertension control

( — An estimated 68 million Americans have high blood pressure and about 20 percent can’t get it under control.

That can have life threatening consequences, including increased risk of heart attack and stroke.

Now some doctors say a minimally invasive treatment could revolutionize the way hypertension is controlled.

Trudi Gombar has tried it all. Diet, exercise and a wide assortment of medications, but her stubborn high blood pressure refuses to come down.

“It’s frustrating,” Gombar said. “I’m on seven different BP medications right now.”

Gombar has what is known as treatment resistant hypertension. That means despite trying three or more medications, her blood pressure remains elevated. She says it came on suddenly several years ago.

“It fluctuates some but it’s always high,” she said. “It’s never normal. It’s always180 or above.”

Then she learned about a possible long term solution.

Doctors at Edward Hospital in Naperville are helping test an experimental procedure called renal denervation.

“I think it’s one of the most exciting innovations in the last 20 years,” said interventional cardiologist Dr. Mark Goodwin.

Scientists have known for years that nerves around the kidneys play a role in blood pressure regulation by influencing chemicals as well as blood flow in the kidneys.

Destroying these nerves might lower blood pressure permanently.

“So what we are trying to do is interfere with that nerve impulse to the kidney and from the kidney to the brain to help lower blood pressure,” Goodwin said.

In renal denervation, a tube is inserted in the groin area and threaded to arteries to cut off nerves running to the kidneys.

That’s done by delivering bursts of radiofrequency energy, a kind of heating technique.

“Do little tiny ablations or burns at different areas of the artery to try and kill the nerve tissue in that area,” said Goodwin.

This ablation procedure is similar to one that’s been used in the heart for years to treat rhythm problems. The Midwest Heart Foundation is also helping test this approach.

“There are no permanent effects on the kidney arteries,” said Dr. Joseph Marek, cardiologist at Midwest Heart Foundation. “They don’t narrow as a result of this and so there appears to be no adverse long term consequences of doing that. And you know, the amount of energy that they deliver here is very small, this microwave energy they use. “


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