High BP despite medication? Here’s how Renal Denervation helps with Resistant Hypertension

Resistant hypertension symptoms: Resistant hypertension may progress gradually, with symptoms such as frequent headaches, dizziness, breathlessness, or occasional chest discomfort (Image: Pexels)

With an estimated 20 crore adults in India suffering from hypertension and only about 2 crore having it under control, according to the Hypertension Control Initiative, the disease has become an urgent health concern requiring immediate attention.

Further, data from the National Family Health Survey shows hypertension prevalence ranging from 16 percent to over 25 percent in some states, with urban areas reporting a higher number of patients whose blood pressure remains uncontrolled despite treatment.

What is Resistant Hypertension?

Resistant hypertension — defined as persistently high blood pressure (≥150 mmHg) despite lifestyle measures and treatment with three or more antihypertensive drugs — is an under-recognised contributor to this challenge, affecting patients’ long-term health and well-being.

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According to the National Family Health Survey, the prevalence of hypertension in Delhi is estimated at 28 percent. Based on clinical practice, an estimated 5–10 percent of hypertensive patients in India are resistant.

Symptoms of Resistant Hypertension

Resistant hypertension may progress gradually, with symptoms such as frequent headaches, dizziness, breathlessness, or occasional chest discomfort. Over time, persistently elevated blood pressure places sustained strain on the cardiovascular system and other vital organs.

How Does Renal Denervation (RDN) Help?

“Renal Denervation (RDN) is an advanced therapy that is minimally invasive, catheter-based procedure that addresses one of the underlying drivers of hypertension — overactive nerve signals between the brain and kidneys. By interrupting these signals, RDN helps lower and stabilise blood pressure over time,” Dr Praveen Chandra, Chairman, Cardiology, Medanta, The Medicity, told Moneycontrol.

He added, “RDN is a one-time procedure that takes about 1 hour to complete. It is done without anaesthesia, with no cuts or stitches, and is generally performed in the same way as an angiography.”

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Talking about hospitalisation and the cost it may involve, he said, “Patients can usually be discharged on the same day or the following day. The cost of the RDN procedure can vary depending on the level of treatment required and patient case history. Whether it is covered by insurance depends on the specifics of the patient’s insurance plan.”

Which Patients are Recommended for RDN?

“This treatment is recommended for patients who continue to have high blood pressure despite the use of three or more medications — at least one of which is a diuretic — at optimal dosages and following all precautions. For such patients, this new technology of renal denervation therapy can be very useful,” the expert said.

“There have been no major side effects noted after this procedure, making it a very safe and effective option,” he added.

Renal Denervation (RDN) Results

The recent clinic experiences have shown positive outcomes among patients, including significant blood pressure reductions—40–45 mmHg systolic and 15–20 mmHg diastolic. Those with a history of stroke and chronic kidney disease showed stable eGFR levels over 9-12 months.

Lowering systolic BP by 10 mmHg reduces the risk of stroke by 27 percent, heart failure by 28 percent, and coronary artery disease by 17 percent. The RDN led to a drop in average number of antihypertensives from 5 to just over 3 per patient. Baseline office BP averaged 186/99 mmHg. Patients saw a near 50 mmHg drop in systolic BP at discharge, with sustained improvements at 1- and 6-month post-procedure.

Better BP control lowers the risk of heart attack, stroke, kidney disease, hospitalisations, and healthcare costs. It improves the quality of patients’ life with fewer medications, fewer hospital visits, and a more active and fulfilling life.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.