Managing high blood pressure with renal nerve denervation

Managing high blood pressure with renal nerve denervation

High blood pressure or hypertension is a serious problem that affects every three in 10 Malaysians with the condition, according to Professor Datin Dr. Chia Yook Chin, Immediate Past President of the Malaysia Society of Hypertension. “Around 1.4 million Malaysians have uncontrolled high blood pressure – whether it’s because they are unaware of their condition or are not on optimal therapy – exposing them to complications like heart attacks, stroke and other heart diseases,” she added.

Renal denervation is a safe and minimally invasive procedure where radiofrequency waves are applied at the renal (kidney) sympathetic nerves to reduce their activity, which contributes to hypertension. It is carried out under local anaesthesia and sedation, with patients usually allowed to go home the day after the procedure. The procedure has been performed successfully in the past at the National Heart Institute (IJN) in Kuala Lumpur.

Preliminary results from an ongoing clinical trial showed that patients with uncontrolled hypertension, despite being on one to three antihypertensive drugs, experienced a 9.0 mmHg decrease in systolic blood pressure and a 6.0 mmHg decrease in diastolic blood pressure (measured continuously over 24 hours via ambulatory monitoring) six months after undergoing the procedure. In comparison, patients who underwent a sham procedure (a renal angiogram, rather than renal denervation) experienced a 1.6 mmHg decrease in systolic blood pressure and a 1.9 mmHg decrease in diastolic blood pressure.

The full results of the trial are expected to be announced in late 2022.

“The drop in blood pressure will be gradual over a number of months and the patient will still need to continue taking their regular medications immediately after the procedure,” explained Dr. Ong Tiong Kiam, co-chair of MyRDN and council member of the National Heart Association of Malaysia.

“The procedure will enable most patients to better control their blood pressure, although it is unlikely, they will be able to completely stop their antihypertensive drugs. The main benefit of the procedure is a decrease in the risk of organ damage and heart disease, like heart attacks and stroke, due to uncontrolled hypertension.”

Professor Datin Dr. Chia and Dr. Ong were joined at the public announcement earlier this week by National Heart Institute senior consultant cardiologist Dato’ Seri Dr. Azhari Rosman, National Heart Association Malaysia President Dr. Alan Fong Yean Yip, and National Heart Association Malaysia Immediate Past President Prof Dr. Wan Azman Wan Ahmad.



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