RENAL DENERVATION
What is resistant hypertension?
Renal artery denervation is a treatment for “resistant hypertension”. This is high blood pressure that hasn’t come back down to normal despite trying three or more medications. This is really important because running high blood pressure increases the risk of heart attacks and strokes.
Some people also find it really tough to tolerate the side effects of blood pressure lowering medicines. Often doctors will try loads of different medicines to find one that suits a patient, but even then it’s a balance of side effects now, or a benefit from lower blood pressure that may be a long way off.
How can renal denervation help?
Renal denervation is a relatively new treatment for high blood pressure that is resistant to conventional medical treatment. It can be considered when patient have not responded to medications, and changes to lifestyle and it has been shown to be effective as a treatment in several clinical trials.
In essence, the procedure involves blocking the nerves to the kidney, which are often giving signals to the body to raise the blood pressure. By blocking these signals the blood pressure is reduced by similar amounts to one or two blood pressure medicines.
This effect appears to be long lived with some clear advantages. The first is that it isn’t dependent on remembering to take the pills. It is also always on – usually the effects of blood pressure tablets wear off at night – so your blood pressure can be higher while you sleep.
What does it involve?
The procedure is done a keyhole technique via the blood vessel in the groin. Plenty of local anaesthetic is given upfront, and the procedure itself is carried out under sedation rather a general anaesthetic. I normally say to my patients that they are “very sleepy” but not “asleep.” We pass a tube up to the arteries of both kidneys with X-rays guiding us. We use heat energy to injure the nerves on both sides. The whole thing takes less than an hour, and patients usually go home the next morning.
Before any renal denervation procedure there will be some scans and blood tests to make sure there are no unusual reasons for high blood pressure and your individual anatomy is suitable for the procedure.
I always want patients to understand that procedures involve risks as well as benefits. This is a very safe procedure, with a low risk of a complication, but we go through this in detail before undertaking any procedure.
Find Out More
Dr Giblett can discuss renal denervation through his private patient clinic at the Rowan Suite. Please contact the Rowan Suite on 0151 6001382 or via privatepatients@lhch.nhs.uk