Hypertension, known as high blood pressure (HBP), is a global epidemic. It impacts a staggering 1.28 billion people, more than a third of the adult population, and is the leading cause of death globally.
The most frightening part?
More than 75 percent of people with HBP don’t have it under control – current treatments, like lifestyle changes and medications, aren’t working for many patients. Millions of Americans, including many of the patients I see every day, are struggling to keep their blood pressure (BP) under control.
We know just how urgent it is to treat HBP early due to the increased risk of heart attack, stroke, and death. We must help bring BP levels down to a safe range to prevent these life-threatening complications. With this urgency comes the hurdles of ensuring we not only have safe and effective treatments but that new solutions are accessible to the patients who might need those options the most.
A challenge to treat: the need for new solutions
As physicians, we employ an individualized care approach to treating patients. However, when we’re treating hypertension, we often encounter challenges like family history as well as medication compliance and lifestyle issues that can make it harder to find a good path forward for each patient.
My colleagues and I continuously notice challenges with patients remembering to take their prescribed medications – if they don’t end up taking their pills, they might not get the desired BP numbers. We understand that for some patients, it can be difficult to stay on top of medication schedules and continue taking drugs that may cause undesirable side effects. Despite the best intentions of practitioners and patients, the numbers don’t lie – current treatment options are missing the mark – and 50 percent of patients are non-adherent to medication therapy within one year.
Additionally, hypertension is the single largest contributor to death, and costs the U.S. health care system more than $130 billion in direct costs every year. These statistics highlight what we have been looking for – an alternative solution for patients with hypertension.
Filling a gap with a third option
All too often, I see hypertension patients of all ages who feel like they’ve hit a wall with treatment options. We’re seeing patients in our clinics with increasing numbers of medications prescribed to control their high blood pressure (HBP). As many people know, lots of those medications, including diuretics, can have even worse side effects than HBP itself.
There is never a one-size-fits-all solution to treating patients. We need a variety of tools in our toolbox, and now we have another potential option to help treat patients. It’s the renal denervation (RDN) system.
RDN disrupts the overactivity between the brain and kidneys through a safe and effective, minimally invasive procedure using radiofrequency energy. This system has achieved blood pressure reductions in the presence and absence of medications, proven in multiple clinical trials and a real-world patient registry including 25,000 patients globally. Data have shown that even small blood pressure reductions significantly reduce cardiovascular risk and major cardiovascular events.
I’m extremely enthusiastic about RDN, as it provides an alternative option for those patients who might not be responding to medications or whose hypertension remains uncontrolled. I’ve conducted a number of procedures since U.S. approval with no complications and all of the patients were discharged on the same day. Over the next several months, my patients saw notable reductions in BP, demonstrating the effectiveness alongside continued medication use. These firsthand experiences continue to show positive outcomes and reinforce my confidence in the technology.
Integrating into our health systems
Along with my excitement for this technology comes my passion to bring RDN awareness to more physicians. Broad education of RDN as a new solution is essential across the care continuum. It is crucial to recognize that RDN is not a standalone procedure but rather a larger component in the overall hypertension care picture.
Establishing trust and creating an understanding of RDN will create a new path beyond the conventional methods to treat HBP, a sentiment that can be reinforced by recent industry guidelines. In 2023, the European Society of Hypertension (ESH) released updated clinical guidelines that reinforce the safety and effectiveness of RDN as a third pillar for difficult-to-control hypertension – along with lifestyle changes and medication. My hope is that this, along with the large patient population, creates a need for hospitals to establish hypertension programs, which can advance patient care by focusing and coordinating efforts to evaluate patients who are dealing with this incredibly common health epidemic. In fact, to ensure that patients are evaluated and sent on the right treatment path, we’ve established a hypertension clinic. Through these efforts, I’m able to select patients who might benefit from another treatment option like RDN.
What is next?
Looking ahead, I believe hypertension clinics can help more patients gain access to potential solutions like RDN. Overcoming and addressing barriers such as awareness and access is also essential for successful implementation. By looking at solutions head-on, health care providers can work to enhance patient access to RDN. It will take the action of institutions and physicians continuing to champion the technology for there to be widespread awareness and adoption of the therapy.
The development of RDN has ushered in a new era for treating a very old problem. Being one of the first physicians to use this technology has been a large milestone in my career. I strongly encourage any physician treating patients with hypertension to explore the options that are now available—RDN could bring durable and sustainable BP results.
Jeremy Bock is a cardiologist.
