Summary of A New Promising Ultrasound Device Could Treat High Blood Pressure:
Researchers at Columbia University and the Université de Paris in France have found that an ultrasound device that calms overactive nerves in the kidneys has the potential to help individuals get their blood pressure under control. The use of the device resulted in a consistent reduction of daytime ambulatory blood pressure by an average of 8.5 points among middle-aged individuals with hypertension. This ultrasound device, which is still investigational and has not yet been approved by the FDA outside clinical trials, could be offered to patients who are unable to get their blood pressure under control after trying lifestyle changes and drug therapy, before heart failure, strokes, heart attacks, and irreversible kidney damage occurs.
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Ultrasound Device Helps Control Blood Pressure in Hypertensive Patients
Hypertension, also known as high blood pressure, is a condition that affects millions of people worldwide. It is a persistent elevation of the pressure of the blood in the arteries, which can lead to serious health problems such as heart disease, stroke, and kidney failure if left untreated. Doctors usually prescribe lifestyle changes, such as reducing salt intake or losing weight, and medications to lower blood pressure in patients with hypertension. Yet, about one-third of hypertensive patients are unable to control their blood pressure despite these interventions. This is where an investigational ultrasound device that calms overactive nerves in the kidneys could be of help.
The Study Conducted by Researchers at Columbia University and the Université de Paris in France
According to a new study conducted by researchers at Columbia University and the Université de Paris in France, the use of the device resulted in a consistent reduction of daytime ambulatory blood pressure by an average of 8.5 points among middle-aged individuals with hypertension. The study pooled data from three randomized trials encompassing more than 500 middle-aged patients with varying degrees of hypertension and medication use.
Kidney Nerves and Hypertension
Hypertension in middle age is thought to be caused in part by overactive nerves in the kidneys, which trigger water and sodium retention and release hormones that can raise blood pressure. (In older people, hypertension often occurs as blood vessels stiffen). Antihypertensive drugs work in different ways to lower blood pressure, by dilating blood vessels, removing excess fluid, or blocking hormones that raise blood pressure. But none of these medications target the renal nerves directly.
How Ultrasound Therapy Works
Ultrasound therapy calms overactive nerves in the renal artery, disrupting signals that lead to hypertension. The therapy is delivered to the nerves via a thin catheter that is inserted into a vein in the leg or wrist and threaded to the kidney.
Study Results
Twice as many patients who received the ultrasound therapy reached their target daytime blood pressure (less than 135/85 mmHg) compared to patients in the sham groups. “The result was almost identical across the different study groups, which definitively shows that the device can lower blood pressure in a broad range of patients,” says Ajay Kirtane, MD, professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and co-leader of the study.
The Benefits of the Treatment
Leaving blood pressure uncontrolled for too long can lead to heart failure, strokes, heart attacks, and irreversible kidney damage. “Renal ultrasound could be offered to patients who are unable to get their blood pressure under control after trying lifestyle changes and drug therapy, before these events occur,” says Kirtane, who is also an interventional cardiologist and director of cardiac catheterization laboratories at NewYork-Presbyterian/Columbia University Irving Medical Center. The investigators expect the treatment could be offered as an adjunct to medication therapy and lifestyle changes for patients with uncontrolled hypertension.
Possible FDA Approval
The results of the study, published in JAMA Cardiology, tested the device, which is used in an outpatient procedure called ultrasound renal denervation. The device is still investigational and has not yet been approved by the FDA for use outside of clinical trials. The treatment will be evaluated by the FDA in the coming months.
Conclusion
The use of an ultrasound device that calms overactive nerves in the kidneys has the potential to help some individuals get their blood pressure under control. Ultrasound therapy calms overactive nerves in the kidney’s renal artery, disrupting signals that lead to hypertension. The therapy is delivered to the nerves via a thin catheter that is inserted into a vein in the leg or wrist and threaded to the kidney. The investigators expect the treatment could be offered as an adjunct to medication therapy and lifestyle changes for patients with uncontrolled hypertension. The treatment is still investigational and has not yet been approved by the FDA for use outside of clinical trials.
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