A one-hour operation that halves the risk of heart attacks in patients with high blood pressure could be available on the NHS from next Spring, doctors said yesterday.
Patients undergoing the keyhole procedure saw their blood pressure drop by a fifth within six months — enough to halve the risk of a heart attack or stroke. A follow-up after 18-months showed no reversal of the condition.
The trials proved so successful that some clinics have already made it available privately, and researchers expect the treatment to be made available to tens of thousands of British patients on the NHS.
The procedure severed the nerves which connect the kidneys to the brain and carry signals to control blood pressure.
Doctors say the operation, which costs just £6,000, could offer a lasting solution for tens of thousands of British patients whose high blood pressure cannot be controlled by conventional drugs. Although people who undergo the procedure still have to take medication to keep their condition in check, it brings about a drop in blood pressure which drugs alone have failed to provide.
Further trials will establish whether the technique, known as renal denervation, could also help patients whose bodies will not tolerate conventional blood pressure drugs.
Findings from the study, which involved more than 100 patients across 11 countries, were presented at the European Society of Cardiology congress in Munich yesterday.
Researchers found that the 20 per cent reduction in patients’ blood pressure was still maintained a year and a half after the procedure, with no major sideeffects reported.
Dr Murray Esler of Saarland University Hospital in Germany said: “We are encouraged to see that renal denervation shows substantial and sustained blood pressure reduction in treatment resistant patients.
“We know the renal nerves play a crucial role in blood pressure elevation and this study shows those nerves can be targeted with renal denervation without major side effects.”
An estimated 16 million Britons have high blood pressure, or hypertension, half of whom are undiagnosed.
Doctors prescribe a variety of drugs to limit the risk of heart disease, stroke and kidney failure, but in up to one in three sufferers the medication proves ineffective.
The new procedure, first trialled at Barts and the London NHS trust in 2009, involves severing malfunctioning nerves around the kidneys.
The nerves send signals to the brain which tell it that blood pressure is too low, causing the brain to increase it to dangerously high levels.
Doctors correct the fault by threading a wire through the renal artery until it reaches the kidneys, where it lets off a burst of heat to burn the nerves and disable them.
Although the operation is moderately painful, it does not require a general anaesthetic and patients can generally leave hospital on the same day.
Charities have so far funded a small number of procedures for patients in severe need, but doctors involved in the trial said they will lobby NHS commissioning boards to make it available to a limited number of treatment-resistant patients next year.
Prof Mark Caulfield, one of the British doctors involved with the study and a spokesman for Blood Pressure UK, said: “At present this treatment has limited availability and has mostly been funded by charitable or other means.
“It will probably be looked at by commissioners for the NHS so that it could be offered to a limited number of patients by April 2013.
“The group this treatment is most applicable for is those who have exhausted all the conventional medications and whose condition is still not controlled...these people are very uncontrolled and therefore have a high risk of having a heart attack or stroke.
“What we would not want to say is that this is a way to get off blood pressure medication, which would be misleading. One or two patients have withdrawn from drugs but the overwhelming majority are still on their medication.”
Prof Peter Weissberg, medical director of the British Heart Foundation, said: “When this [treatment] came out it was a question of whether it was going to last, because it sounded too good to be true. Eighteen months isn’t that long, but it seems as if it does last.
“If the evidence is available to show it is useful and effective then NICE will agree it should be done on the NHS - whether there is enough evidence to convince them of that, I don’t know.
“Renal denervation will become part of the management of this group of difficult-to-treat patients in the future, it is just a question of how long that takes.”
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