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Can Hard-To-Treat Hypertension Be Tackled? Some 78 million people in the United States, or about 1 in 3 adults, have hypertension (high blood pressure). These people have blood pressure readings of 140/90 mmHg or higher. 140 is systolic reading and 90 is diastolic reading. By 2030, an additional 27 million people will develop hypertension too, according to a forecast made by the American Heart Association (AHA). This is based on the fact that people are getting fatter and older. As a matter of fact, if people can live long enough, most of them will have hypertension. About 50 percent of people who are 50 and above, and 75 percent of people who reach the age of 75 can develop hypertension. Changing one’s lifestyle, eating healthy diet and regular exercise, could no doubt help lower the elevated blood pressures. But changing lifestyle alone to fight hypertension would often take a long way to achieve and majority of hypertensive patients will still require medications to help control their blood pressure. Doctors will usually prescribe different category of medications to different patients depending on their stage of blood pressure and whether they also have other medical problems.
Hypertension usually has no warning signs or symptoms and many people do not realize that they are hypertensive. That is why it is often called the ‘silent killer’. Ignoring or not having hypertension controlled can be disastrous since hypertension is a risk factor that will lead to heart disease, stroke and kidney failure. Nevertheless, only about half of the hypertensive patients have their blood pressure under control, and most of them require multiple drugs for treatment. There is some 10 percent patients have resistant hypertension, meaning these people’s blood pressure remains stubbornly high despite taking at least 3 or more different kinds of high blood pressure drugs. It is estimated that resistant hypertension affects nearly 100 million people worldwide. For nearly a century, medications have been offering convenient and noninvasive treatment for many diseases. But it seems that for some of the most chronic conditions, including diabetes, obesity and hypertension, relying on medications is simply not enough. Scientists are inventing new hypertension equipment and testing many different approaches for the toughest to treat hypertensive patients. One of the methods is to burn some overactive nerves deep in the body to curb the hike in blood pressure. In this invasive treatment, a catheter is threaded through vessels in the groin up to the kidneys. Many daily events can no doubt raise one’s blood pressure. For the majority, these increases are just temporary and would not have lasting impact on the health. But for a certain group of people, sometimes the blood pressure remains high because some nerves stay switched on when they are not supposed to. This is something today's medications cannot tackle. As such, companies like Medtronic are revisiting an old technique called ‘renal denervation’ to destroy those ‘misbehaved’ nerves to calm an overactive system, relaxing arteries and lowering blood pressure. While renal denervation had already been performed in the 1950s to help lower blood pressure, it also caused permanent injuries to the patients. Recently, easy-to-use catheters are developed to beam radiofrequency waves to burn away specific nerves without damaging the surrounding blood vessel. In some small Medtronic studies, the new technique had brought the systolic reading down by an average of 33 points for patients who were also on prescribed hypertensive medications. According to a report by Medtronic in March 2012, such improvements could last up to 3 years. But it is still premature to confirm that there will not be any adverse effect in the long run. It is understood that more than 60 companies are continuously pursuing devices for hypertension, from catheters similar to Medtronic's to permanent implants left in arteries to regulate blood pressure. This definitely brings hope to people with resistant hypertension that cannot be treated by medications alone.
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