Lower blood pressure without medication

• Ultrasound renal denervation seems effective and safe according to a study published in Jama.  
• At 2 months of follow-up, this type of denervation reduced the daytime systolic blood pressure of middle-aged people with hypertension who had discontinued antihypertensive medications compared to a control procedure, with no major adverse events being found.

Why it matters

• Many patients with hypertension are not treated adequately despite the two cornerstones of antihypertensive therapy, lifestyle changes and pharmacotherapy, being widespread.
• In previous studies, renal denervation with ultrasound lowered the blood pressure of patients with mild to moderate or treatment-resistant hypertension.

How the study was conducted

• The RADIANCE II study, conducted at 37 U.S. and 24 European centers, included patients with a mean age of 55 years with uncontrolled hypertension despite taking antihypertensive drugs (up to 2) and estimated glomerular filtration of at least 40 mL/min/1.73 m2.
• Eligible patients who after 4 weeks of drug washout had outpatient PS/PD of at least 135/85 and PS/PD less than 170/105 were randomized to undergo denervation (150) or renal angiography (sham procedure, 74).
• Participants were not required to take medication for the 2 months of follow-up, except in special cases.

Main results

• At 2 months, daytime ambulatory PS decreased more with denervation (mean: -7.9 mmHg) than with the control procedure (mean: -1.8 mmHg).
• The effect was consistent during the 24-hour circadian cycle with similar decreases in blood pressure during the day, night and early morning.
• Denervation also improved 6 of the 7 secondary blood pressure outcomes (including PS in the 24 hours).
• The effect on diurnal PS was homogeneous across all subgroups.
• No major adverse events were detected in either group.

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Source — https://www.univadis.it/viewarticle/abbassare-la-pressione-senza-farmaci-2023a100048g