Houston VA Performs Its First Renal Denervation for Stubborn High Blood Pressure. Here Is What It Is, and What Comes First

Veterans in Houston whose blood pressure will not come down have a new option.

The Michael E. DeBakey VA Medical Center recently performed its first renal denervation, a minimally invasive procedure that targets nerves that can drive blood pressure up, according to a VA News article published Oct. 30.

The account of the procedure comes from the VA alone; we did not find independent reporting on it. The general guidance below comes from the National Heart, Lung, and Blood Institute.

What the procedure does

Near the kidneys are nerves that can become overactive and send signals that raise blood pressure, the VA explains. In the procedure, a system called Symplicity Spyral guides a thin tube to those nerves and delivers a quick burst of energy to quiet them. Nothing is left behind in the body. There is no implant or permanent hardware.

The hospital is offering it to "select Veterans with resistant hypertension," said Dr. Glenn Levine, the center's chief of cardiology, meaning blood pressure that stays high despite treatment.

"High blood pressure forces blood to push too hard against artery walls," Levine said. "Over time, this damages organs throughout the body and can cause heart failure, kidney failure and strokes. Controlling blood pressure is critical to our Veterans' overall health."

Dr. Jing Liu and the hospital's cardiac catheterization lab team performed the first case, the VA said.

Not a shortcut

The VA is careful to say renal denervation is not a replacement for diet, exercise or medicine. It is meant as an added help when those are not enough. The VA article says about 80% of people diagnosed with high blood pressure still struggle to control it with medicine and lifestyle changes alone.

For most people, the National Heart, Lung, and Blood Institute says, a health care provider will build a treatment plan around heart-healthy habits, alone or with medicine. If high blood pressure is caused by another condition or a medicine, it may improve once that cause is treated or removed.

What comes first

NHLBI lists the everyday steps that help lower and control blood pressure:

Eat heart-healthy foods, such as those in the DASH eating plan. NHLBI-funded research found DASH combined with a low-salt diet can be as effective as medicine at lowering high blood pressure.

Avoid or limit alcohol, and talk with your provider about how much you drink.

Move more. Even walking 10 minutes a day may help, and so can sitting less.

Aim for a healthy weight. For adults with overweight or obesity, losing even 3% to 5% of body weight can improve blood pressure.

Quit smoking. The National Cancer Institute's quitline is 1-877-448-7848.

Manage stress, and get seven to nine hours of good sleep each night.

NHLBI suggests making one change at a time and adding another once the first feels comfortable.

When medicine is needed

When habits alone do not do the job, providers prescribe medicines that work in different ways. Common ones include ACE inhibitors and angiotensin II receptor blockers, which keep blood vessels from narrowing as much, calcium channel blockers, which help blood vessels relax, and diuretics, which remove extra water and salt. Many people need two or more medicines, NHLBI says. If side effects bother you, tell your provider rather than stopping on your own; the dose or drug can be changed.

Research suggests that getting systolic blood pressure, the top number, below 120 can lower the risk of serious complications, according to NHLBI. Your provider can help you decide what goal is right for you.

A fair word

Many veterans carry the physical cost of their service for decades. It is good to see a Texas VA hospital adding new tools for them. But the body God gave us responds to daily stewardship: a walk, a lighter salt shaker, a full night's rest and a pill taken faithfully. Know your numbers, and ask your doctor what yours should be.

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