A New Method In Treatment Of Hypertension: Renal Denervation

Renal Denervation is a safe and effective treatment option that can be applied interventionally in Liv Hospital Cardiology Clinic for treatment of hypertension

Hypertension is the leading preventable cause of heart attack, stroke and death. Targeted blood pressure levels cannot be reached in more than 50% of the patients despite effective medication use. Non-compliance with medication use is a serious problem in particular. As many patients are resistant to daily medication use or their willingness to take medication is weak, success of treatment is very weak. 

Uncontrolled hypertension can trigger ischemic heart disease, stroke, cerebral hemorrhage, renal failure and other cardiovascular diseases, thus leading to death. 

The rate of awarenss of high blood pressure is about 50% in our country. That is, one out of every two patients lives exposed to complications without knowing that they have high blood pressure. About 50% of patients diagnosed with hypertension are receiving treatment. Control rate of the disease is 30% in patients receiving treatment. That is, effective blood pressure control cannot be achieved in seventy of a hundred patients. 

Effective controlling of blood pressure

Scientific studies have clearly shown that every 10 mmHg decrease in cystolic blood pressure reduces the risk of major cardiovascular events such as death, heart attack and stroke by 20%, and by 13% in deaths caused by all reasons, 28% for heart failure, 27% for stroke and 17% for chronic ischemic heart disease. 

Extensive and combined treatment approach in hypertension

Hypertension treatment is a whole. Change of lifestyle is the first step for this. Limited salt intake, regular physical activity and raising patient awareness are the basics of this step. Second step is the medication treatment. Usually, lifelong use of multiple medications and patient compliance are required. On the other hand, interventional treatment is a complementary treatment step that is safe, and its outcomes are permanent and independent from patient compliance for life. 

How does Renal Denervation treat high blood pressure?

Kidneys play a key role in the control of blood pressure.  Sympathetic nerve fibers that provide the connection between the central nervous system and the kidneys and basically play a key role in the release of stress hormones function excessively in patients with high blood pressure and cause excess release of stress hormone. Uncontrolled activation of these smypathetic nerve fibers that extend around and near renal arteries causes excessive and uncontrollable increased in blood pressure. Renal denervation procedure targets these overactive fibers in patients with high blood pressure and aims to lower the blood pressure.

How is Renal Denervation procedure performed?

It is a painless procedure performed under local anesthesia. Bilateral renal arteries are entered by passing through the inguinal artery using angiographic techniques. Radiofrequency energy is applied to the symathetic fibers adjacen to the artery with the help of special renal denervation catheter that is sent to both renal arteries (successively). Inguinal artery is exited with angiographic technique at the end of the procedure, entry point of the inguinal artery is closed and the patient is placed under monitoring, then discharged the next day.

Who can undergo Renal Denervation?

• Resistant hypertension patients who still have high blood pressure despite taking optimal medication treatment
• Patients who do not have effective medication use due to side effects of the medications
• Non-compliance of medication use (patients who do not regularly take/neglect/do not use prescribed medications)
• Patients with high risk of cardiovascular event and/or organ damage due to hypertension

Renal Denervation should not be considered as a basic method that can replace change of lifestyle and medication treatment, which are the basis of treatment of hypertension. However, it is a treatment option that strengthens the physician’s hand in the extensive treatment of hypertension as a conventional complementary interventional method that increases the effectiveness of treatment in suitable patients.