Health Team

New procedure could treat resistant hypertension

High blood pressure is a major problem for older adults in the United States, with more than half of people over age 50 dealing with some form of hypertension.

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DURHAM, N.C. — High blood pressure is a major problem for older adults in the United States, with more than half of people over age 50 dealing with some form of hypertension. 

If left untreated, high blood pressure increases the risk of stroke, heart attack and even kidney failure. But for many patients, lifestyle changes and medications don't always lower the risk. 

Peggy Kunnen, a 57-year-old patient at Duke University Hospital, has dealt with hypertension for more than two years. She's taken multiple medications in different combinations, but nothing worked effectively.

"It was 270 over 140 the other day at the doctor's office," Kunnen said of her inflated blood pressure, which should be around 120 over 80.

Laura Svetky, a hypertension specialist at Duke, said that many people like Kunnen develop a resistant form of hypertension that does not respond well to treatment. In an attempt to fight this new form of high blood pressure, doctors at Duke are currently testing the results of a procedure called Sympathetic Denervation, a procedure that targets nerves near the kidneys the release hormones to the brain.

In the procedure, a catheter tip is sent through a major artery in the leg and up to the kidney arteries, where it burns certain nerves.

"It appears that [resistant hypertension] is at least in part due to over activity of the adrenal nervous system," Svetkey said. "That's the 'fight or flight' nervous system." 

Duke Hospital cardiologist Manesh Patel believes the procedure could be effective. 

"The signals for high blood pressure are stopping, so the kidney doesn't release these hormones," Patel said. "We have encouraging results from the prior studies that make us think this is an option for many of these no-option patients."

For Kunnen, Sympathetic Denervation provides new hope in her fight against high blood pressure.

"Maybe, hopefully, they can take me off some of my medications," she said.

For more information on the Resistant Hypertension Program, call the Heart Center referral number at 919-681-5816 and selecting option two or three. Patients and providers can also learn more about renal denervation online.

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