New Treatment Option for High Blood Pressure: Renal Denervation!

In the last two decades the innovation in medical care has evolved faster than ever before due to advancement of technology, and our ability to objectively study disease treatment better than everbefore in well organized clinical trials. 

The rapid development of new treatments has increased the life expectancy of our population. The care for heart artery blockage (new stents, medication, techniques),  heart valve treatment (Transcatheter Aortic valve replacement), diabetes care (multiple new class of diabetes medications), Cholesterol management (Multiple new molecule to very aggressively control the cholesterol) and even cancer care has improved immensely with multiple new treatment options. Unfortunately there has been no new treatment option for the  number one killer of human race, ie. High Blood Pressure, in the last two decades.  We have been using the same class of medications to improve blood pressure control. 

The new updates of HTN guidelines in 2017 were written by the scholars with two major principles. 1. HTN is the world's greatest risk factor for death and disability. 2. Preventing cardiovascular events requires aggressive management of high blood pressure. Hypertension (High BP)is considered the number 1 killer as it causes negative irreversible changes to cardiovascular health over years. The uncontrolled or chronic high blood pressure causes: irregular rhythm of heart, congestive heart failure, heart attack, stroke, kidney failure, atrial fibrillation, dementia and visual impairments. Most patients do not have any symptoms, sio the compliance to the medication is low. Almost 50% of patients stop their BP medication by 1 year from starting. 

Over the years of exploration through basic science research and clinical research it has become evident that overactive sympathetic nervous system plays a major role in causing (etiopathogenesis) of Hypertension. Sympathetic nervous system (SNS) controls the body's fight and flight response. SNS is part of the autonomic nervous system and it regulates and controls all the organs that continuously function without human conscious awareness such as Heart, Lung, Kidneys etc. The overactivity of the SNS is upregulated by the renal nerves that travel in the peri-adventitial surface (outside the walls) of the renal (kidney) arteries. 

Renal Denervation is a procedure in which by using either electrical, ultrasound or chemical energy we disable (zapp) the peri-renal nerves, which in-turn tone down the overactive sympathetic nerves. One such technology is Paradise ultrasound renal denervation catheter. 

We studied the effectiveness of this treatment  device (Paradise Ultrasound Renal Denervation Catheter)  in lowering high blood pressure in patients suffering from severe resistant hypertension. In this clinical trial called RADIANCE HTN, we treated half of patients with three antihypertensive medications combination alone and the other half of the patients we treated with renal denervation and the same three antihypertensive medications. The patients who were treated with Renal Denervation have significantly more reduction of blood pressure by 8mm of hg. This was a remarkable improvement for patients suffering from severe resistant hypertension. It is very exciting and encouraging for medical fraternity and patients suffering from chronic uncontrolled high blood pressure to have a new option of treatment by undergoing a one time minimally invasive procedure.

I was fortunate to lead this clinical trial here in New Jersey as a primary Investigator. We enrolled the  highest number of patients in the world and acquired the largest experience of this novel procedure of Renal Denervation. Over the last 8 years I have invested immense efforts in researching the new treatment option for high blood pressure and have been primary investigator for multiple clinical trials exploring treatment of Hypertension (High Blood Pressure) 

The results of this trial were presented at the American College of Cardiology annual scientific meeting as a late breaking trial and simultaneously published in the Lancet. 

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00788-1/fulltext#seccestitle10

We will continue to follow these patients. If the safety and effectiveness is maintained on the longer term follow-up Renal Denervation procedure may become an alternative to adding more medication for controlling blood pressure. We will continue to investigate this treatment in different forms. Currently we are investigating patients with mild or severe resistant High blood pressure with different forms of Renal Denervation treatment. 

If you are suffering from High blood pressure and interested in exploring alternate treatment for High blood pressure instead of taking medications, please reach out through our website: www.njhvc.com

Remember, the lifestyle measures of controlling salt intake, DASH diet, meditation, aerobic exercise, quitting smoking are all the other measures you must take to improve blood pressure control. It is hard to take medications on a regular basis but the compliance reduces the risk of cardiovascular events such as heart attack and stroke.   The better the blood pressure control you have, the less likely you will suffer a heart attack, stroke, kidney failure or heart failure. 

"Prevention is always better than cure".

Author
Kintur Sanghvi MD FACC FSCAI Kintur Sanghvi MD FACC FSCAI Dr. Kintur Sanghvi has been intensely focused in learning, researching and teaching cardiovascular medicine since age 23. After practicing in a legendary academic teaching hospital for 11 years in NJ, acquiring experience of over 10,000 cardiovascular procedures; publishing multiple research articles, book chapters, and training over 100 cardiologist, he has decided to open NJ Heart & Vascular Care to provide: A personalized, compassionate and comprehensive care in all the areas of Cardiology, Interventional cardiology and Endovascular Medicine. He has been internationally acclaimed and has given talks as guest faculty in multiple countries across 5 continents. . With deep interest in problems solving, he has innovated and published multiple new procedures, techniques, and device solution and owns multiple patents. The Practice’s motto is: It is truly a privilege to provide cutting edge, evidence-based care to each patient, one at a time.

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