Hypertension, commonly known as high blood pressure, is a chronic health condition that affects millions of people worldwide. It is a significant risk factor for heart disease, strokes, and other potentially severe health issues.

Despite the availability of various medications and lifestyle changes, not all hypertensive patients manage to control their blood pressure levels. However, recent medical advancements have made significant progress in treating hypertension through surgical procedures.

Understanding Hypertension and Its Risks

High blood pressure is a condition where the force of blood against the artery walls is consistently too high.

Hypertension can be caused by a variety of factors, such as age, genetics, sedentary lifestyle, obesity, excessive alcohol consumption, dietary choices, and medication side effects. If left untreated, hypertension can lead to other health complications, such as aneurysms, kidney damage, vision loss, and cognitive impairment.

People suffering from hypertension are usually prescribed medications such as diuretics, calcium channel blockers, and ACE inhibitors. However, medication treatment may not always work or may have unwanted side effects.

For instance, some patients cannot tolerate medication due to allergies or drug interactions. Besides, some hypertensive patients’ blood pressures remain uncontrolled and pose higher health risks even with medication.

What is the hypertension-reducing surgery?

The hypertension-reducing surgery, also known as renal sympathetic denervation (RSD), is a minimally invasive surgical procedure that aims to reduce high blood pressure in chronic hypertensive patients.

The RSD procedure targets the sympathetic nerves that control blood pressure regulation in the kidneys, known as the renal nerves. The sympathetic nerves carry signals between the brain and other parts of the body, including the arteries. When these nerves are overactive, they cause the arteries to constrict, leading to high blood pressure.

The RSD procedure interrupts these signals, lowering blood pressure in a short time.

How is the hypertension-reducing surgery performed?

The RSD surgery is typically performed by an interventional cardiologist, with the patient under local anesthesia.

Using an X-ray imaging device, the physician inserts a catheter through a small incision in the groin and threads it up to the renal arteries, where the renal nerves are located. Tiny electrodes are then inserted through the catheter and placed near the nerves. The electrodes emit radiofrequency energy, which generates heat.

This heat destroys the sympathetic nerves, thereby reducing the overactivity of these nerves and lowering blood pressure.

The RSD surgery’s benefits and potential risks

The RSD surgery’s primary benefit is that it can lead to significant reductions in blood pressure levels in hypertensive patients.

According to studies, the RSD surgery can lead to an average reduction of 30 points in systolic blood pressure and 11 points in diastolic blood pressure. Moreover, the RSD procedure may be an effective treatment option for hypertensive patients who do not respond well to medications or lifestyle changes alone.

The potential risks of RSD surgery are usually minimal and include issues closely connected with catheterization procedures, such as bleeding, bruising, or infections around the incision point.

More severe complications, such as kidney damage, are rare, yet they might occur during the procedure, depending on the patient’s anatomy or a physician’s experience. However, medical professionals administer medication to the patient before surgery to minimize these potential risks and provide post-operative care to manage any resulting complications.

The Success Rate of the hypertension-reducing surgery

With the recent progress made in hypertensive surgery, the RSD procedure is increasingly used worldwide to treat chronic hypertension.

Many studies have been conducted, and the RSD surgery’s success rate is an essential consideration for hypertensive patients considering surgical intervention. The newest studies indicate that this procedure has a success rate over 59% for the hypertensive population between 26-79 years old.

What are the criteria for patient selection for the RSD surgery?

Not all hypertensive patients are suitable candidates for the RSD surgery. To qualify for this surgical procedure, patients should meet specific criteria, such as:.

Being diagnosed with hypertension
Uncontrollable blood pressure levels even with medications or lifestyle adjustments
Not having secondary high blood pressure causes such as kidney failure, adrenal gland tumors, or sleep apnea
Being under the age of 85 years old, unless health conditions permit otherwise
No previous history of renal artery stenosis or vascular disease in the pelvic area that would interfere with the catheterization procedure

Conclusion

Minimally invasive surgery, such as the RSD procedure, is a viable and effective option for chronic hypertensive patients who fail to respond to medications and lifestyle adjustments.

The RSD surgery reduces hypertension and lowers the risk of cardiovascular diseases and complications related to high blood pressure. Always consult a hypertensive specialist to discuss your treatment options and determine the best choice for your health condition.