Good news for high blood pressure, both shocking and sweet

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A zap to the kidneys might safely reduce hypertension in patients whose high blood pressure is resistant to three or more medications. The new treatment works by deactivating nerves in the kidney (renal denervation) using a catheter that sends a burst of radio frequency energy directly to kidney nerves. The Lancet reports on the results of the Simplicity HTN-2 trial, which monitored blood pressure in 49 drug-resistant hypertension patients who underwent denervation while continuing their blood pressure drug regimen, as well as 54 patients who only received drug therapy for six months. At the end of the follow-up period, 84 percent of patients who received renal denervation treatment experienced a blood pressure reduction of at least 10 mm Hg compared with 35 percent of the control patients. Renal denervation patients did not sustain any increase in complications compared to the control group.

ACSH's Dr. Gilbert Ross thinks that the novel treatment shows promise, but emphasizes that it is only for hypertension patients who can t control their blood pressure with multiple medications a relatively small proportion of patients. The results of this trial are significant for patients with difficult to control high blood pressure. This therapy should be further evaluated, hopefully in the near future; if it s found to be safe and effective, the criteria for treating patients with this technique will probably be widened, and more patients with less severe hypertension will be able to receive this relatively non-invasive treatment. This is a small study, but powerful as far as its results, and given the potential benefits to the number of people with triple treatment-resistant hypertension, it could be ground-breaking.

There s more good news for hypertension patients a small Swedish study published in the November Journal of Cardiovascular Pharmacology shows that consumption of dark chocolate appears to have a beneficial effect on a hormone produced by the kidney that is a major factor in regulating blood pressure. Researchers from Linkoping University found that eating dark chocolate inhibits angiotensin-converting enzyme (ACE), which is secreted by blood vessels in the kidney. The study authors had 16 volunteers eat 75 grams (2.5 ounces) of dark chocolate with a cocoa content of 72 percent and measured their ACE levels 30 minutes before eating the chocolate and in two instances afterwards. ACE levels dropped an average of 18 percent from levels measured before indulging in the chocolate, which is comparable to therapeutic effects seen with ACE-inhibiting blood pressure medications.

Dr. Ross wishes the researchers had also measured blood pressure to determine if chocolate could actually reduce hypertension. That seems to be an important parameter that could easily have been measured simultaneously, and I am perplexed why this was not reported.