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Renal denervation: minimally invasive procedure to lower blood pressure
More than every third person in Germany has high blood pressure. Hypertension is the leading cause of heart attacks, strokes and cardiovascular events. Hypertension is usually treated with medication. However, many people do not want to take medication regularly, cannot tolerate it or forget to take it. A new therapy can help here.
Renal denervation has been shown to be effective in a U.S. approval study. The procedure was tested at 33 centers in 46 centers in nine different countries (also in Germany). Renal denervation is a minimally invasive procedure on the kidney nerves that significantly lowers blood pressure. The study results were recently published in the renowned journal "The Lancet".
Hypertension is often treated with medication
Between 30 and 50 percent of Germans have high blood pressure. There are numerous methods of doing this. Those who do not get their blood pressure under control through regular exercise, losing weight and eating healthily usually resort to lowering blood pressure. The common problem here is that those affected do not take the prescribed medication regularly or in too low a dose, which means that the treatment does not achieve the desired effect.
Influence blood pressure directly at the point of origin
For this reason, non-drug treatment for hypertension has long been sought. For some time now, renal denervation has been proposed as such a possibility in medical circles. The current international study shows that the procedure is effective. The idea behind this is to influence blood pressure at the point of origin - in the kidneys.
What is done with renal denervation?
The entire human stress nervous system is regulated in the kidneys. In addition to regulating water and sodium, this also includes regulating the resistance of the blood vessels. This is where renal denervation begins. The outer wall of the arteries of the renal arteries is precisely sutured at certain points via a catheter in the renal artery. And exactly at the places where the stress nerve fibers of the renal arteries run, whereby the transmission of stimuli is interrupted.
What are the effects of the intervention?
All 331 participants in the study had a blood pressure between 140 and 180 mmHg and received no drug therapy. The subjects received either renal denervation or sham therapy as a control of effectiveness. The blood pressure was then documented over three months using 24-hour measurements.
"In the group treated with renal denervation, the practice blood pressure was reduced by 9.2 mmHg and 4.7 mmHg in the long-term blood pressure measurement during this period," explains Professor Dr. Michael Böhm, spokesman for the German Society for Cardiology, who presented the study at a congress. His team checked the procedure in the Clinic for Internal Medicine III at the Saarland University Hospital.
Is the procedure approved in Germany?
"The statistical analysis shows a 99.9 percent probability that the effectiveness of renal denervation is superior to a sham intervention," says Böhm. A study that is currently being carried out in parallel is investigating whether there are similar effects in patients whose high blood pressure is already being treated with medication. "From the current study results, we can conclude that renal denervation in patients with non-adjusted hypertension offers a further therapy alternative in addition to lifestyle changes and drug treatment," concludes the professor. The broad approval of renal denervation is currently being discussed. (vb)
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Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Graduate editor (FH) Volker Blasek
- Michael Böhm, Kazuomi Kario, David E Kandzari, u.a .: Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomized, sham-controlled trial; in: The Lancet, 2020, thelancet.com
- German Society for Cardiology - Cardiovascular Research: Minimally invasive intervention lowers blood pressure (published: April 8th, 2020), dgk.org