WASHINGTON (AP) — Doctors were unable to control Michael Garrity’s dangerously high blood pressure with prescribed medications, until they utilized a procedure to disrupt overactive renal nerves in his kidneys. This new treatment targets the nerves that play a role in regulating blood pressure. Garrity, 62, from Needham, Massachusetts, experienced significant improvement, with his blood pressure now at normal levels for the first time in years, allowing him to reduce his medication dosage. Approximately half of U.S. adults suffer from high blood pressure, a condition that poses serious health risks such as heart attacks, strokes, and kidney failure. Dr. Randy Zusman of Massachusetts General Hospital emphasizes the importance of knowing one’s blood pressure numbers and recommends regular check-ups for those who believe they are healthy. With only a fraction of patients successfully managing their hypertension, innovative approaches are needed. The FDA approved the “renal denervation” procedure a year ago, following studies showing benefits in patients unresponsive to multiple medications. This minimally invasive procedure, now cautiously offered by hospitals like Mass General Brigham, aims to identify suitable candidates and address insurance coverage for a treatment that costs thousands of dollars.
High blood pressure, indicated by two numbers representing systolic and diastolic pressures, can lead to artery stiffness and increased heart workload if left untreated. Normal blood pressure is below 120 over 80, but consistent readings at 130 over 80 or higher require attention. Monitoring blood pressure doesn’t always necessitate a doctor’s visit, as screenings are available at pharmacies and libraries, and at-home monitors can be used following recommended guidelines to ensure accurate readings.
In addition to medication, lifestyle adjustments are crucial in managing high blood pressure. Weight loss, physical activity, well-balanced diet, limited salt and alcohol intake, and stress management are key factors highlighted in treatment guidelines. For those with severe or treatment-resistant hypertension, like Garrity, who despite multiple medications and rigorous lifestyle changes continued to struggle with high blood pressure, renal denervation offers a potentially effective solution. This procedure involves threading a catheter through blood vessels to target specific nerves in the kidneys with ultrasound or radiofrequency energy, aiming to disrupt their function and reduce blood pressure levels.
An interventional cardiologist who carried out Garrity’s procedure stated that the process typically lasts approximately one hour. Despite prior utilization in various countries, a pivotal clinical trial of renal denervation in the United States proved unsuccessful about ten years ago, resulting in alterations before researchers embarked on a second attempt. In November 2023, the Food and Drug Administration (FDA) sanctioned two catheter systems developed by Recor Medical and Medtronic.
While not heralded as a cure – and with certain patients experiencing no discernible advantages – Garasic noted that multiple research studies indicate an average decrease of 8 to 10 points in blood pressure, representing a modest yet significant enhancement. Some patients, such as Garrity, have reported even more substantial reductions, leading to a gradual reduction in the intake of medications. The FDA affirmed the safety of the procedure for carefully selected patients, excluding individuals with kidney conditions or constricted arteries from testing. Furthermore, research durations have been limited to a few years, raising uncertainties about the potential for nerve regeneration over time.
The American Heart Association’s recommendations emphasize the necessity for potential patients and seasoned medical practitioners to engage in thorough and informed dialogues to determine suitability for the procedure.
The Associated Press Health and Science Department benefits from the support of the Science and Educational Media Group of the Howard Hughes Medical Institute, as well as the Robert Wood Johnson Foundation. The AP retains full responsibility for all content.
