For resistant hypertension, here is ultrasound which “calms” the nerves in the kidney
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A very fine tube is inserted into a vessel of the leg or wrist. Then, slowly, it reaches the kidney. Once it reaches its destination, the device releases ultrasound that somehow works like a real “targeted anxiolytic“. Thanks to this treatment, in fact, the aim is to selectively deactivate some nerve endings that are found along the external walls of the renal arteries. And in doing so, a protracted reduction in pressure is induced when the drugs are really not sufficient to restore the maximum values and minimally to levels desired by the physician based on the person’s risk.
This approach, which has already been performed for some time with other modalities such as radiofrequency, also works with the administration of simple ultrasounds. To say it is a research that has seen allied scholars from the Universities of Columbia and Paris, which appeared in JAMA Cardiology. According to the results of the study, the device that releases ultrasound it could make it possible to reduce blood pressure values by more than 8 points on average in middle-aged subjects, in association with treatments and healthy lifestyles.
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by Federico Mereta
How it helps act on the nerves
The data presented in the study refer to over 500 adult patients with hypertension of various degrees and subjected to pharmacological treatments, obtained in three different trials. Compared to the control groups who only continued the previous treatment, the number of patients who reached the proposed blood pressure values below 135/85 millimeters of mercury was almost double. “The result – as it detects Ajay Kirtane of Columbia University, one of the authors of the research – was almost identical in the different study groups, which definitively demonstrates that the device can lower blood pressure in a large patient population.
The treatment, currently still under evaluation, was well tolerated. Most of the patients in the study did not have to stay in the hospital the night after the therapy. The treatment “turns off” the activity of the sympathetic nervous system which has an influence on blood pressure. In fact, the nerve signals directed to the kidneys help regulate renal blood flow, salt retention and activation of the renin-angiotensin system, which interacts with pressure. In the opposite direction, the signals that from the kidneys go to the nervous system trigger many mechanisms that can favor the increase in blood pressure. Renal denervation attempts to dampen activity along this two-way pathway.
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How to recognize resistant hypertension
Renal denervation treatments, whether already available and widely tested with positive results such as radiofrequency or soon to be used in the clinic, must be used appropriately. In other words, it is necessary that potentially treatable people have a clear diagnosis of resistant hypertension: in general terms we speak of the picture when a valid control of the systolic and diastolic blood pressure levels is not obtained even using three different drugs at the maximum tolerated dosage, with a diuretic be part of the cocktail.
Then other checks are needed, such as 24-hour blood pressure monitoring, the certainty that the patient follows the prescribed treatments carefully, the emotional response to the doctor’s visit, the possible presence of hypertension linked to other mechanisms, therefore secondary.
It is therefore important to distinguish between “uncontrolled” hypertension and “resistant” hypertension. However, there are many safe and usually effective drugs, so before talking about truly resistant hypertension, use a specialist who can also approach the picture with more medicines.
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Why resistant hypertension is dangerous
The presence of resistant hypertension, therefore of blood pressure levels constantly higher than desired, can represent an additional danger for those who already have high risk profiles for cardiovascular diseases, such as heart attack or stroke. To understand the weight of this parameter, we can refer to a study that included more than 200,000 patients: in the presence of resistant hypertension, the risk of experiencing non-fatal myocardial infarction, heart failure, stroke and kidney disease was 47% greater in the almost four years of observation.
Another research on nearly 400,000 people reveals that if there is resistant hypertension, the risk of chronic renal failure rises by more than 30% and that of stroke by 14%.
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