Revolutionary operation could 'cure' high blood pressure

[bik0]

only available in the U.K. though...

In what is being hailed as the most exciting development in the field for 50 years, doctors can treat the condition with a simple procedure in under an hour.

It could allow some sufferers to come off medication completely and offer hope for those for whom existing treatments have no effect.
The technique, which is relatively straightforward and cheap for the NHS, could reduce the risk of a major heart attack or stroke in such patients by half.

http://www.telegraph.co.uk/health/healthnews/6788476/Revolutionary-operation-could-cure-high-blood-pressure.html

[Sarah Ibarruri]

1. That would be wonderful! nt

[enlightenment]

2. Very interesting.

It sounds like a promising development.

[Way2go]

3. The operation sounds very unappealing. nt

[Vickers]

4. How so?

:shrug:

[Fire_Medic_Dave]

9. Angiotensin 2 is in the body for a reason.

Stopping the kidneys from ever being able to release it may not be the wisest choice.

[timeforpeace]

27. Isn't this the same group who "discovered" that amputating your legs prevents stubbing your toe?

[silverweb]

5. We may get it here soon...

... if Big Pharma allows it. Or maybe not, since they'd be losing billions in chronic drug requirements.

We can hope.

[Fire_Medic_Dave]

8. That's why they are so against vaccines right? LOL.

They could make so much more money if they just let those diseases make people ill and cripple them.

[silverweb]

25. That statement makes no sense whatsoever.

[Fire_Medic_Dave]

36. Why would big pharma create vaccines when they can make more money treating the diseases?

If what you allege is true?

[jmowreader]

10. Big Pharma would love it

because they could either (1) fire the people who make the relatively cheap drugs used to treat hypertension--drugs that have in many cases been on the market so long even the generics makers can't make money from them--or (2) have those people start making dick pills instead of hypertension pills.

[Fire_Medic_Dave]

12. The drugs this treatment would replace still have patent protection.

They would be the class of angiotensin II receptor antagonists, almost all still have patent protection for several more years.

[jmowreader]

20. And they're expensive as shit, too

CheapoDrugs.com sells Cozaar 25mg tablets, which they bring in from Barbados in New Zealand packaging, for $121.89/90 tablets. Not being familiar with this class of drug, is this something physicians prescribe routinely or do they tend to go with the old drugs that still work?

[silverweb]

28. Good article on that subject:

ACE inhibitors are common and cheap; angiotensin receptor blockers (ARBs),including Cozaar (generic name losartan), are not. Both offer protections beyond control of hypertension.

A somewhat technical but not really difficult to read article is _here_.

[Fire_Medic_Dave]

I take Cozaar it was the first drug they tried me on for hypertension.

Of course I'm very fit, not overweight and have no other health problems besides high triglycerides. It cost me $40 in co-pay as compared to $5 for generics. Of course most of the other hypertension meds have significant side efects. The only side effect I have from cozaar is fewer headaches. My doctor usually gives me a 4 to 6 month supply of samples. So I have no complaints about cozaar. I'm kind of fond of medications that work well without any side effects though.

[Christa]

14. You hit the nail on the head

They would not want a cure as it would shave billions of dollars off their profits.

[silverweb]

26. We'll have to wait and see...

... but that's my thought. Sad, isn't it?

[Christa]

31. Very sad

we are in a real life tragedy of gigantic proportions.

[leftofcool]

6. Even if it was available here, you insurance wouldn't pay for it

[SoCalDem]

7. one question though, if the nerve is supposed to trigger hypertension

is it a reaction to the kidney disease?..would blocking it, just mask the kidney disease , while stopping the hypertension?

Is it like treating a fever which is trying to tell you about an underlying problem CAUSING the fever?

[Fire_Medic_Dave]

11. Possibly. The kidneys release angiotensin 2 because they need more blood.

[northernlights]

16. well sort of

kidneys normally release Angiotensin II when they need higher hydrostatic pressure to increase glomerular filtration to maintain sodium and H2O balance and/or regulate BP. Its release can be triggered by changes in the sodium/H2O balance in the glomerular filtrate, by a drop in BP sensed by the afferent arterioles or by the sympathetic nervous system.

In the meantime, presumably doctors won't start destroy nerves willy-nilly without first diagnosing the actual underlying cause. Oftentimes, kidney damage is secondary to an underlying disease. Same with high blood pressure.

[Fire_Medic_Dave]

17. I was just going for something most people would understand.

[northernlights]

19. then you stopped typing one word short...

they release angiotensin 2 because they need more blood *pressure*. ;) the volume of blood remains the same in the kidneys; angiotensin 2 vasocontricts the afferent arteriole artery, causing blood to back up into the glomerulus, where it increases the glomerular filtration rate.

[Fire_Medic_Dave]

33. I guess I thought that was implied with it being the cause of hypertension.

Thanks for keeping me on my toes and for explaining it more thoroughly.

[REP]

37. Normotensives with nephrotic syndrome are put on ARBs to reduce proteinuria

I'm actually hypotensive (90/40, with or without ARBs) and take them for nephrotic syndrome associated with my primary idiopathic FSGS.

[Fire_Medic_Dave]

40. Interesting, learn something new everyday. Thanks for sharing.

Hope all is going well for you.

[northernlights]

13. kidney diseases come wih a raft of symptoms...

and hypertension is symptomatic of many diseases. Generally, with kidney disease I don't think that hypertension is the definitive symptom that clinches diagnosis.

Eg, the diabetic patient cited in the article would have had many symptoms, plus abnormal blood and urine chemisry; hypertension was just an another one.

[amborin]

15. +1

it's dubious any operation can cure standard run of the mill hypertension

it's typically a result of slow changes to the intima of the arteries, the lining, which changes over time and involves complex chemical changes in the metabolism of the cells

it's typically a systemic condition, not amenable to surgery

[Fire_Medic_Dave]

18. Kidney disease doesn't often reveal itself until function is quite impaired.

It is possible the hypertension is one of the early signs.

[amborin]

24. true

yet in most cases, the arrows are reversed and it's the hypertension causing the kidney disease

[Fire_Medic_Dave]

34. What if.

It is possible that it actually is the kidney disease that's causing the hypertension but because kidney disease doesn't present as a factor until late we deem it to be caused by other factors and the culprit in relation to the kidney disease. I know nephrologists are the true geeks in med school and I'm sure this has been figured out by people far brighter than I.

[amborin]

35. i don't know

think i read that even early kidney disease would get detected through blood tests....

certain high protein levels?

albumin?

i forget....

[Fire_Medic_Dave]

38. Nope kidney function has to drop below 50% before any routine bloodwork changes.

I've been round and round on this one with my dad. My sister told them my dad had kidney failure (not true) I had to do quite a bit of study and call a few doctor friends to get it straightened out. All of the docs I spoke with said function had to get below 50% before it showed up on any tests. Of course there is always something new out there so maybe they can detect things faster now. My dad's stroke was in April though so it hasn't been long.

David

[REP]

42. Not true unless my docs are lying to me

I'm at about 60-70% function and my GFR and other tests reflect that. Then again, they know I'm a kidney patient, so my GFR isn't rounded to the "not dying" number.

[Fire_Medic_Dave]

44. Sorry I added routine to blood tests.

Probably no point in doing the tests you are talking about when the function is below 50%. Like I said though just a medic and definitely no the sharpest tool in the shed.

[amborin]

43. interesting!

but what about those blood test printouts that tell a person what their readings are for each different category, and then also give the high and low range for that category? don't they give a person an idea of where their reading is along the continuum?

otherwise: i'm sorry about your dad, i hope he gets better quickly!

[Fire_Medic_Dave]

45. Lot's of factors I think. One cardiac enzyme can remain elevated with decreased kidney function.

Everyone was freaking out saying dad had a heart attack (no one would do a 12 lead but they were sure :eyes:) I stayed st the hospital for 36 hours talking to different docs only to have them not be able to answer my questions and leave and send another doc in. Finally a cardiologist came in and said almost 100% sure no heart attack just the reduced kidney function which showed up in the cardiac labs on occasion. They did a transesophageal echo and ruled it out definitively. I think a variety of things can skew blood result numbers, I'm no lab expert many here are though hopefully they'll chime in. Dad's doing okay, back in the hospital battling 2 pulmonary emboli and a broken femur after a fall. He's in a rehab hospital now. Thanks for the good thoughts.

[northernlights]

47. early kidney disease is detected primarily through urinalysis

combined with bloodwork, symptoms and patient history. If the kidneys are not function properly, then urine will contain the wrong things, or not contain the right things.

For example, by the time one has developed chronic glomerulonephritis, the urine protein levels are > 2.5 g/day and the urine is isosthenuric. By the time the patient is in nephrotic syndrome, protein levels are > 3.5 g/day and serum albumin is low (hypoproteinemia). Normal protein levels are only 100 mg/day...considerably lower than at the point that hypoproteinemia is detected.

But the protein mat on the dipstick is sensitive to very low levels of protein, and the results for urine protein are correlated with urine blood, white cells, gram - bacteria, and SG.

And abnormal results on dipstick and physical exam of urine (color, clarity and in some cases odor) mandate microscopic analsysis as well.

[REP]

39. Possible, but not all kidney disease present with hypertension

Diabetic nephropathy, for example; minimal change disease for another (I'm not trying to be a dick or argue for argument's sake; I think this stuff is fascinating, in part no doubt because have one of the more poorly understood and least treatable kidney diseases, idiopathic focal segmental glomerolusclerosis).

[Fire_Medic_Dave]

41. Sorry didn't mean to imply that.

[northernlights]

46. actually a simple dipstick urinalysis

can indicate impaired kidney function before any other symptoms occur. Even on random specimens, but especially on 1st morning void.

[Fire_Medic_Dave]

49. Conclusively and to what degree?

[Obamanaut]

21. Weight loss, diet modification, and cardio exercise help also. nt

[greenman3610]

22. I think it's politically incorrect

to suggest that this is a problem that is easily solved if one
gives a shit about taking care of one's self.

[northernlights]

48. the article makes clear it's not a substitute for proper care of oneself

The kidneys are one of our body's two major regulators of blood pressure. There are certain diseases -- they can be hereditary or acquired -- that cause hypertension/high blood pressure. Some of these diseases are incurable, or can only be controlled. Over time some diseases damage the kidneys and in so doing, cause hypertension. This procedure relates to those diseases, and only those diseases.

[ThomThom]

23. This could never be done here. Doctors want those kick back

for prescribing drugs especially heart meds

[KamaAina]

29. Only available in the UK?

But, but, but how can innovation possibly come from a pinko socialist commie gummint-run health care system?! :sarcasm:

[canetoad]

30. Operation to cure high blood pressure?

Having your eyes removed so you can't read GDP. :evilgrin:

Seriously, this is great news.

[davsand]

32. I am extremely interested in seeing if this pans out.

I am one person that has had a lot of problems taking drugs for hypertension. I was diagnosed over a year ago, and I am still looking for something to reduce my blood pressure that won't leave me feeling worse than before. I have tried the ACE Inhibitors, I have tried the ARBs, and I have tried Calcium Channel Blockers. Side effects have ranged from my hair falling out, to serious joint pain to pant-wetting coughs, to shortness of breath. Literally, I have joked about the "Pill Of the Month" but this is discouraging. I refuse to take a pill that makes me feel WORSE--it just makes no sense to me.

Right now I am in month two of Tekturna--a Renin Inhibitor--and it has been one of the least offensive drugs thus far. I DO have a cough that is bad enough that other people have commented on it, and I do have increased problems with my allergies. I'm snotty a lot of the time, and that cough is getting old, so I dunno if this one is gonna work either.

Beta Blockers are not an option (tried them in eye drops a few years ago and the Docs said do not do this again) andI am just about out of drug types to try.

You have to know that if I could have an out-patient surgery done and have it work safely I'd be all for it.



Laura