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September 18, 2012

A New Surgery May Cure High Blood Pressure

Wouldn't it be nice if you could cure high blood pressure by taking a pill or by means of a simple surgical procedure? Well, the medical community has tried the former, with mixed results so far; certainly, they haven't found a magic pill that permanently drops your BP to a safer level.

But there may be a surgical way to significantly reduce hypertension. A new procedure called Renal Sympathetic Nerve Ablation has produced outstanding results in recent trials, knocking down recipients' systolic BP by an average of 28 points.

Caveats First

Now: before I go any further, full disclosure. RSNA is an experimental procedure that surgeons have performed on a relative handful of people at this time (52 people took part in the initial study, which began in December 2009). It's not yet widely available worldwide, and may not be for quite a while.

And RSNA is rarely a full cure. Some patients saw their systolic pressure drop as little as 10 mm after the procedure (the average drop was from 178 mm to 146 mm, or about 20%). Furthermore, surgeons recommend the procedure only for those who can't otherwise control their BP; in other words, it's not for everyone.

Accentuating the Positive

That said, it's early days yet. As the research is pursued further (and it will be, given the results), surgeons may discover ways to increase the surgery's effectiveness and extend it to more patients.

The great news is that RSNA is very safe, reduces hypertension significantly at least 80% of the time, and the effects appear to be long-term, if not permanent. Plus, it doesn't require a general anesthetic, and patients usually go home at the end of the day.

Surgeons are testing a similar procedure called "renal denervation" in Australia and Canada. So far, no one undergoing any of the surgeries has suffered major complications.

The Details

In case you were wondering, here's how these surgeries work: the surgeon basically uses a hot wire to deactivate the nerves attached to the artery that feeds blood to the kidneys. It takes about an hour.

We've known for over fifty years that the kidneys play a significant role in regulating blood pressure. If the communication path between the brain and kidneys is cut, one's BP tends to fall.

The Bottom Line

No one is quite sure where RSNA and its sister surgeries will take us, and at the moment, very few hypertensive individuals are candidates for the procedures. So don't get your hopes up too high yet.

But don't give up hope, either. At the very least, these procedures offer a glimmer of hope that someday, we'll be able to cure high blood pressure surgically.

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