Simple surgery offers hope to millions with high blood pressure

Millions of people with untreatable high blood pressure were given hope yesterday by the development of a surgical procedure that can dramatically cut the risk from the condition.

High blood pressure is the biggest risk factor for premature death worldwide, affecting one in three adults. It increases the incidence of strokes and heart attacks and affects 16 million people in the UK.

Most people can reduce their blood pressure by drinking less alcohol, eating less salt and taking more exercise, or with drugs prescribed by doctors. But 10 to 20 per cent are unable to control the condition with available medicines. The new treatment offers an alternative way of cutting blood pressure without the use of drugs. Though millions could be treated with the new proceedure, economic realities mean the NHS would limit its application.

The minimally invasive procedure is similar to angioplasty for heart disease but involves deactivating nerves in the kidney which play a key role in regulating blood pressure. A catheter is inserted into the femoral vein in the thigh and threaded through to the kidney. Then a burst of radio-frequency energy is used to disable the nerves.

A trial of the technique run in 24 hospitals worldwide, including in the UK, found the technique cut blood pressure levels by a sufficient margin to halve the risk of dying from heart attack or stroke.

The 100 patients in the study, half of whom underwent the procedure, had average readings of about 178/97mm Hg at the start of the study, which were well above the threshold for high blood pressure – 140/90mm Hg. Six months after treatment, 84 per cent of those who underwent the procedure had significant reductions in blood pressure.

Patients in the UK were treated at Barts and the London NHS Trust starting last December. No patients suffered major complications.

Professor Graham MacGregor, who is the chairman of the UK's Blood Pressure Association, said: "This is exciting research which could play a part in tackling the massive issue of high blood pressure. More research will first need to be done into how safe and effective it is in the long term."

Professor Mark Caulfield, director of the William Harvey Research Institute and a joint leader of the UK arm of the trial, said: "I am delighted that this study has shown substantial falls in blood pressure in patients with severe uncontrolled hypertension on multiple medicines. It offers a novel route to reduce blood pressure and cardiovascular risk in people who have exhausted conventional treatment."

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