Minimally invasive kidney procedure can help control blood pressure
Ultrasound energy shown to benefit patients who cannot keep to medication
Brief pulses of ultrasound delivered to nerves near the kidney can produce a clinically meaningful drop in blood pressure in people whose hypertension does not respond to a cocktail of medications . That ’ s according to a trial that suggests that so-called renal denervation has the potential to become an important add-on for patients who have difficulty managing several medications to control their high blood pressure .
The kidney plays a role in blood pressure by controlling how much water is in the bloodstream . Renal denervation , a minimally invasive procedure , uses ultrasound energy to disrupt signals from overactive nerves in the renal arteries .
About two-thirds of people who take medications to lower blood pressure are able to control their condition . But in others , the drugs do not work or patients do not take them as directed .
“ There ’ s a variety of effective medications for lowering blood pressure , but many people need to take several drugs to control their hypertension , which can have side effects . In addition , many people simply don ’ t want to take additional medications and are poorly adherent to them ,” said Dr Ajay Kirtane , a professor of medicine at Columbia University and co-principal investigator of the trial .
The trial found that daytime blood pressure after two months had dropped eight points compared to a three-point drop in patients who were treated with a sham procedure . Night-time blood pressure decreased by an average of 8.3 points in the treatment group versus 1.8 points in the sham group .
A drop in blood pressure of eight points , if maintained over longerterm follow-up , will almost certainly help reduce the risk of heart attack , stroke , and other adverse cardiac events .
Study suggests that exercise is best treatment for depression in cardiac patients
Fitness found not only to improve depression but to lower blood pressure and cholesterol
Exercise is probably the most effective short-term treatment for depression in people with coronary heart disease and has benefits over antidepressants and psychotherapy , scientists in Ireland have found .
In the first systematic review to compare treatments for depression in coronary disease patients , the findings provide valuable clinical information to help doctors determine the best treatment plan for patients .
The researchers reviewed treatment trials that investigated antidepressants , psychotherapy , exercise , combined psychotherapy and antidepressants , and collaborative care .
To measure effectiveness , they looked at factors including patient dropout rates and changes in depressive symptoms eight weeks after commencing treatment .
The strongest treatment effects were found to be exercise , while psychotherapy and collaborative care did not perform very well .
“ Depression is common in patients with coronary artery disease . Having both conditions can have a significant impact on the quality of life for patients , so it is vital that they have access to the most effective treatments ,” said Dr Frank Doyle , a senior lecturer at the Royal College of Surgeons in Ireland and the study ’ s first author .
“ Our study indicates that exercise is likely to be the best treatment for depression following coronary artery disease . Our findings further highlight the clinical importance of exercise as a treatment as we see that it improves not only depression , but also other important aspects of heart disease , such as lowering blood pressure and cholesterol , in these patients .”
GlobalHealthAsiaPacific . com JUNE 2021
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