December 2011:

Resistant High Blood Pressure What Now?

New Catheter Ablation Procedure Lowers the Values

Some patients still have high blood pressure despite taking a combination of three or four antihypertensive medications. These patients can be helped by a new procedure used to lower the blood pressure. The procedure is known as percutaneous renal denervation and is performed in the Department of Internal Medicine / Cardiology, headed by Prof. Fleck.

A special heart catheter and high-frequency electricity are used to deactivate (cauterize) particular nerves in the renal arteries. The sympathetic nervous system in the area of the renal arteries plays an important part in controlling the blood pressure, although it is not the only factor. New studies show that the systolic and diastolic blood pressure can be reduced by up to 30 mmHg/15 mmHg and thus in many cases returns to within the normal range.

The aim of all antihypertensive treatment is to prevent so-called end-organ damage, i.e. damage to the heart, kidney and vessels, caused for example by a stroke, a myocardial infarction or kidney weakness. The catheter intervention on both renal arteries lasts between 45 and 60 minutes under sedation; a general anesthetic is not necessary.

The benefits cannot be judged until some weeks later. In this time the patient continues to take the previous blood pressure medicine. Studies have so far shown that no complications occur after this procedure.