Ultrasound Catheter Offers New Treatment Option for Hypertension

For patients diagnosed with hypertension, the typical course of treatment involves lifestyle modifications, such as reducing salt intake and losing weight, coupled with medications to reduce blood pressure. Nevertheless, despite these interventions, approximately one-third of hypertensive patients are unable to regulate their blood pressure. This can lead to detrimental consequences, such as heart failure, strokes, heart attacks, and irreversible kidney damage. Now, a device that employs ultrasound-based technology to calm overactive nerves in the kidneys could potentially aid certain individuals in controlling their blood pressure.

A study led by researchers at Columbia University (New York, NY, USA) and Université de Paris (Paris, France) found that the device significantly lowered daytime ambulatory blood pressure by an average of 8.5 units in middle-aged individuals with hypertension. It is believed that hypertension in middle age is caused, in part, by overactive nerves in the kidneys that trigger water and sodium retention and release hormones, thereby raising blood pressure. Antihypertensive medications regulate blood pressure through different mechanisms, such as dilating blood vessels, removing excess fluid, or blocking hormones that increase blood pressure. However, none of these medications directly target the renal nerves. Ultrasound therapy reduces the overactivity of nerves in the renal artery and disrupts the signals that lead to hypertension. The treatment is administered to the nerves through a thin catheter inserted into a leg or wrist vein and threaded up to the kidney.

The latest research analyzed data from three randomized trials involving over 500 middle-aged patients who had varying degrees of hypertension and were treated with different medications. It was discovered that twice the number of patients who underwent ultrasound therapy achieved their targeted daytime blood pressure (less than 135/85 mmHg) compared to those in the control groups. The treatment was well-tolerated, and most patients were released from the hospital the same day. The researchers observed improvements in blood pressure just a month after the procedure. The treatment is anticipated to be reviewed by the FDA in the near future. The researchers believe that this treatment, when used with medication therapy and lifestyle changes, could be a valuable tool in controlling unmanageable hypertension.

“Renal ultrasound could be offered to patients who are unable to get their blood pressure under control after trying lifestyle changes and drug therapy, before these events occur,” said Ajay Kirtane, MD, professor of medicine at Columbia University Vagelos College of Physicians and Surgeons and co-leader of the study. “Once the device is available, we envision recommending it to patients who have tried other therapies first. The hope is that by controlling blood pressure, we might be able to prevent kidney damage and other effects of uncontrolled blood pressure.”

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Columbia University
Université de Paris