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Renal denervation to treat resistant hypertension

Dr Andreas Baumbach & Dr Angus Nightingale, UHBristol, Professor Julian Paton, University of Bristol

A new technique for reducing high blood pressure has been successfully trialled in the Bristol Heart Institute. It involves removing the nerves connecting the kidney to the brain and has been shown to significantly reduce blood pressure and help lower the risk of stroke, heart and renal disease in patients with resistant hypertension, where patients develop resistance to their tablets, or where tablets are ineffective.  The procedure, which has very few side effects, has already shown promising results in hard-to-treat cases of high blood pressure.

Professor Julian Paton had already found in laboratory studies that in an animal model of hypertension removing nerves connecting the kidney to the brain reduced blood pressure and improved its long-term stability.  Dr Angus Nightingale and Dr Andreas Baumbach then adopted the technique called "renal denervation" to remove the nerves to the kidney in patients with high blood pressure.

The procedure, which has been successfully trialled on 19 patients at the Bristol Heart Institute, is performed using a fine tube that is inserted in an artery in the patient's leg and positioned in the artery feeding blood to the patient's kidneys. The nerves to the kidney are around the artery and ablated by radio-frequency energy that is emitted from the tube.

The technique is very straight forward, performed as a day case and there are no side-effects. It is becoming a popular technique for patients with both resistance and poor tolerability to high blood pressure medication. The aim is for the technique to be offered as part of normal care for these patients.

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