New Treatment Offers Hope for Tough-to-Control High Blood Pressure
WASHINGTON (AP) — For Michael Garrity, managing dangerously high blood pressure had been an ongoing struggle, despite countless medications. That was until doctors introduced a new treatment: a procedure that targets nerves in his kidneys.
This innovative therapy, known as renal denervation, aims to disrupt overactive nerves that play a role in regulating blood pressure. By doing so, it helps to lower blood pressure in individuals like Garrity, who had found little relief from traditional medications.
“My blood pressure would spike, leaving me out of breath and exhausted,” said Garrity, 62, of Needham, Massachusetts. “Now, I feel normal for the first time in years. I still take some medicine, but at much lower doses.”
High blood pressure, or hypertension, affects nearly half of U.S. adults and is a major contributor to heart attacks, strokes, kidney failure, and even dementia. Many people remain unaware of their hypertension until it causes severe damage.
Dr. Randy Zusman, a hypertension specialist at Massachusetts General Hospital, emphasizes the importance of regularly monitoring blood pressure, even for those who feel healthy. “Know your numbers,” he advises. “Get checked at least once a year.”
For many, traditional medications alone are not enough to bring blood pressure under control, making innovative treatments like renal denervation critical. The procedure, which the Food and Drug Administration (FDA) approved about a year ago, is especially beneficial for patients whose blood pressure remains high despite multiple medications.
The American Heart Association recently endorsed this approach, and hospitals such as Mass General Brigham are cautiously adopting it while determining which patients are ideal candidates—and whether their insurance will cover the costly, minimally invasive procedure.
What is High Blood Pressure?
Blood pressure is measured by two numbers. The first, systolic pressure, reflects the force of blood against artery walls as the heart pumps. The second, diastolic pressure, measures that force between heartbeats. A normal reading is under 120/80 mmHg. Blood pressure consistently higher than 130/80 mmHg can lead to damaged arteries, causing the heart to work harder.
How to Monitor Blood Pressure
Blood pressure monitoring is simple and doesn't require a visit to the doctor. Many pharmacies and libraries offer free screenings, and there are home monitors available. For accurate readings, the American Medical Association advises sitting quietly with your feet flat on the floor, placing the cuff on bare skin, and resting your arm on a table.
Managing High Blood Pressure Beyond Medication
Lifestyle changes are essential for managing high blood pressure, especially in otherwise healthy individuals. Losing weight, exercising, eating a balanced diet, and managing stress can all help. Once blood pressure reaches 140/90 mmHg, medication is usually necessary, and patients often require multiple drugs alongside lifestyle changes.
Garrity’s hypertension, however, was resistant to all standard treatments. Despite using a combination of four to six medications, along with a strict diet and exercise regimen, his blood pressure would often reach 150/100 mmHg or higher.
Renal Denervation: A New Approach
The renal denervation procedure involves inserting a small catheter into the blood vessels to reach the kidneys. Using ultrasound or radiofrequency energy, doctors disrupt the nerves that help regulate blood pressure. The entire procedure typically takes about an hour.
While it has been used successfully in other countries, the treatment's approval in the U.S. followed a decade of research. In 2023, the FDA approved two catheter systems, from Recor Medical and Medtronic. Though not a cure, studies show a modest, yet significant, reduction in blood pressure—typically an 8 to 10-point drop. Some patients, like Garrity, experience even greater improvements, enabling them to lower their medication dosages.
Though the procedure is considered safe for patients who meet specific criteria, it is not suitable for those with kidney disease or narrowed arteries. The long-term effects remain unclear, as the studies conducted so far have only lasted a few years.
The American Heart Association encourages patients to have in-depth discussions with their doctors to determine if renal denervation is a viable option.