HealthCheck

New approach to controlling high blood pressure

Tuesday, September 04, 2012

A new report from the CDC says out of the 67-million Americans with high blood pressure, more than half don't have it under control. There's now a trial underway to control blood pressure when medication fails.

Joe Amedeo's life is driven by his faith, a faith he shares several days a week when the retired Brick, N.J. man ministers at a local hospital.

"It's very satisfying to me, and hopefully to them," he says.

But like many Americans, Joe struggles with high blood pressure.

He's tried dozens of medications, however, none seem to work for long.

"Some worked okay, and then all of the sudden, it would spike," Joe notes.

So he got involved with a trial at Deborah Heart and Lung Center, where doctors are testing a new technique targeted at the kidneys. It's called the Symplicity system, manufactured by Medtronic.

Dr. Richard Kovach, the director of the cardiocatheterization lab at Deborah, describes the problem.

"There's a neurological pathway that runs from the brain to the kidneys and back to the brain again, which helps modulate and control blood pressure," he says.

Dr. Kovach says if this circuit becomes overactive, it pumps out excess amounts of chemicals that raise blood pressure.

Sometimes, that nerve circuit gets stuck "on," making it hard for medications to bring blood pressure under control.

So at Deborah, they're running small catheters from the groin up to the renal arteries. Then they apply radiofrequency energy to the nerves inside the vessels to stop that cycle.

"So we actually damage and/or destroy those nerves and interrupt that feedback loop," says Dr. Kovach.

The trial is blind, so Joe doesn't know yet whether he got the actual procedure.

But he says it was easy. Doctors say killing the nerves won't hurt kidney function for the future.

Dr. Kovach and his partner in the trial, Dr. Jon George, hope the Symplicity system can be an alternative to medication. Medtronic says the Symplicity system has been successfully used by 4,000 patients in Europe, Asia, and other nations for several years.

"Over all these years, we've only come so far in controlling blood pressure, we need new targets," says Dr. George.

The CDC report points to a real need for fresh approaches.

More than half of those with uncontrolled blood pressure know they have problems, see a doctor twice a year, and are taking medication.

For them, either medications are not working or they are not taking it correctly.

For more information, go to Deborah Heart and Lung Center or www.clinicaltrials.gov.

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