Discover how ultrasound treatment is helping hypertensive patients control blood pressure. The experimental procedure is a promising secondary option.
- A new meta-analysis finds that therapeutic ultrasound could be a useful tool to help lower blood pressure in individuals with hypertension.
- The renal denervation device used in the study involves a thin catheter inserted into a vein and threaded into the kidney to inhibit nerve activity using ablation.
- Although the device is experimental and not yet approved for use in the United States, continued trials may pave the way for a more permanent option for blood pressure control, particularly for minority populations with high rates of hypertension and heart disease.
As a cardiologist, I am always on the lookout for new treatments that can help my patients manage their blood pressure.
Recently, a new study published on JAMA Cardiology caught my attention, and I wanted to share the findings with you.
A new meta-analysis found that therapeutic ultrasound to calm kidney-nerve hyperactivity significantly lowered blood pressure among people with hypertension in three randomized clinical trials.
The ultrasound technique, known as “renal denervation,” may help physicians offer patients an additional tool to manage their blood pressure.
Renal Denervation: What Is It, And How Does It Work?
Renal denervation is a technique that uses ultrasound to treat overactive nerves in the kidneys.
During the procedure, a thin catheter is inserted into a leg or wrist vein and threaded into the kidney.
Nerves in the kidneys are treated with ultra-high-frequency sound waves that produce tiny amounts of scar tissue to inhibit nerve activity.
This process is called “ablation.”
Dr. Ajay J. Kirtaine, the lead author of the study, explains that the ablation portion for ultrasound-renal denervation is less than one minute, and the overall procedure is less than an hour, with conscious sedation/local anesthesia.
The ultrasound denervation procedure is an outpatient procedure similar to a cardiac catheterization procedure.
What Did The Study Find?
The study, conducted by researchers from Columbia University and Université de Paris, followed 506 participants with hypertension.
In the studies, one group of participants received the ultrasound denervation, while another group, the control group, received a sham procedure with no therapeutic value.
Twice as many individuals in the study arm that received the treatment achieved their blood pressure goals of 135/85.
This result was consistent across the three studies with a racially diverse population, suggesting the procedure’s value is likely to be widespread.
The studies followed participants for two months after the procedure and found that the improvement in blood pressure lasted at least that long.
Dr. Kirtaine said the effect of the procedure:
“Appears to be durable with follow-up out to three years.”
Is Renal Denervation Safe For Everyone?
The device is experimental so far and has not received approval for use in the United States.
The authors of the study envision its use in patients whose blood pressure remains uncontrolled despite lifestyle modification and medication.
Cardiologist Dr. Jayne Morgan, who was not involved in the study, suggests the procedure may be especially helpful for minority populations with high rates of hypertension and heart disease, particularly Black individuals.
However, Dr. Devin Kehl, not involved in the research, cautioned that the procedure’s inclusion and exclusion criteria have been pretty restrictive.
For example, most patients in the study did not have many comorbidities.
Renal denervation is associated with low procedural risk, but it’s not a zero procedural risk.
So it’s important to discuss with your doctor if the results can be extrapolated to you.
Ultrasound denervation appears to be a promising treatment option for hypertension.
Although the procedure is still experimental and not yet available for use in the United States, it may help physicians offer patients an additional tool to manage their blood pressure.
If you’re struggling to manage your blood pressure despite lifestyle modifications and medications, talk to your doctor about renal denervation and whether it could be an option for you.
Patient-Level Pooled Analysis of Ultrasound Renal Denervation in the Sham-Controlled RADIANCE II, RADIANCE-HTN SOLO, and RADIANCE-HTN TRIO Trials. JAMA Cardiol. Published online February 28, 2023. doi:10.1001/jamacardio.2023.0338