Treatment for Hypertension in Oxford
If you have been diagnosed with hypertension, your long-term treatment will depend on the severity of your condition, your personal preferences, and how well you respond to medication or lifestyle changes. You may have to try different medications before you and your GP settle on a program that works.
Is high blood pressure the same as hypertension?
The terms ‘high blood pressure’ and ‘hypertension’ may be used interchangeably, however they are not quite the same. Your blood pressure can be considered high-normal when it is between 130/85 mmHg and 140/90 mmHg, whereas readings above 140/ 90 mmHg are diagnosed as hypertension.
| Normal range | Systolic BP (mmHg) | Diastolic BP (mmHg) | ||
| Optimal | < 120 | And | < 80 mmHg | |
| Normal | 120-129 | And / Or | 80-85 | |
| High Normal | 130-139 | And / Or | 85-90 | |
| Hypertension range | Mild Hypertension | 140 – 159 | 90 – 99 | |
| Moderate Hypertension | 160 – 179 | 100 – 109 | ||
| Severe Hypertension | >180 | >110 |
It’s important to get your hypertension under control to avoid increasing your risk of heart disease or stroke.
Lowering your blood pressure by 10 mmHg can:
- Reduce your risk of cardiovascular events by 20%
- Reduce your risk of heart failure by 28%
- Reduce your risk of stroke by 27%
Treatments for hypertension
As shown above, hypertension is diagnosed when your systolic blood pressure is above 140 mmHg, and your diastolic blood pressure is above 90 mmHg (i.e., 140/90). Any treatment you undergo will aim to bring your blood pressure values below this threshold, and ideally achieve a systolic blood pressure between 120 and 130 mmHg. This is especially important if you have diabetes, history of heart disease, or have suffered a stroke.
There are three main treatments available for bringing your hypertension under control:
1 | LIFESTYLE CHANGES
1 | LIFESTYLE CHANGES
For mild hypertension with no other risk factors, making lifestyle changes may be enough.
2 | MEDICATION
2 | MEDICATION
For moderate to severe hypertension, or mild with other risk factors, you may need a combination of medications.
3 | RENAL DENERVATION
3 | RENAL DENERVATION
For resistant hypertension or intolerance to medications, you may benefit from a renal denervation procedure.
Renal Denervation Treatment for Hypertension – your questions answered
Generally, RDN is suitable for those who have uncontrolled medium to high hypertension and are already on several types of medications, or have experienced side effects from most blood-pressure medications. Your GP or consultant cardiologist will help you decide whether this procedure is right for you.
The aim of renal denervation is not discontinuing the tablets, but to ensure optimal blood pressure control, as this is what drives a reduction in the risk of stroke or heart attack.
There is however a good chance that the dose or number of tablets might be decreased after the procedure. However, the procedure is considered a success even when a patient, who had initially poor blood pressure control on medications, achieves optimal blood pressure values afterwards, even though this requires taking all or some of the initial medications.
An extra benefit, possibly associated with the procedure, is that the effect on blood pressure is always ON when compared to medications that have an effect on blood pressure only when the patient remembers to take his/her tablets.
Renal Denervation treatment for hypertension in Oxford is a relatively straightforward procedure. Some people can go home the same day of the procedure, some may need an overnight stay.
Usually about a week, after which many people return to their normal activities. Your doctor will monitor you and let you know when you are ready.
Generally, you may have two follow-up appointments; one with the consultant who performed your procedure, and one with your GP.
Renal denervation has a well demonstrated safety-profile. However as in any invasive test/procedure, complications can occur. The cardiologist performing the procedure, or your GP, can discuss this in more detail.
Injury to the kidney or narrowing of the renal artery are possible serious complications, though extremely rare with an incidence reported in clinical studies below 0.5%.
The most common side effect associated with renal denervation is bleeding at the entry site (groin) where the puncture is made to insert the catheter to perform the procedure. In clinical studies no major bleeding complications have been described.
The occurrence of bruising/haemathoma at the entry point though is not uncommon. This can sometimes be source of discomfort for a few days/weeks after the intervention, but it usually responds well to painkillers and tends to resolve spontaneously over time.
This is variable according to the vessels’ anatomy, but an average procedure can take around 60 minutes.
The procedure can be painful at the stage when energy is delivered to disconnect the nervous fibres. For this reason, it is performed under local anaesthesia, analgesia, and deep sedation, meaning that the patient is usually not awake during the procedure, but still able to breathe spontaneously without need of assistance of specific medical equipment. The level of awareness during the procedure can vary from individual to individual, with most patients typically sleeping throughout; though there are rare scenarios when some degree of vigilance remains.
The short answer is no, as the procedure aims at reprogramming the connections between the brain and the kidney and this cannot happen immediately. Roughly, the effect of the procedure becomes manifest between 3 and 6 months, even though there have been cases with quite immediate response after a few days.
Please keep in mind, like for any therapy, there is roughly a 20% chance of absence of response. Unfortunately, we currently cannot predict ahead of time who will be and who won’t be a good responder to this treatment.
According to the available data, the effect on blood pressure seems to be well maintained over time and well reflected by the observation that nerves around renal arteries do not regrow. The most solid data confirmed a maintained lowering blood pressure effect at least up to 3 years, but data supporting maintained effect on blood pressure beyond 3 years are growing.
How Can I get Renal Denervation Treatment for Hypertension in Oxford?
- Renal denervation is available privately at The Manor Hospital in Oxford.
- There is also currently a Renal Denervation Clinical Trial underway at the John Radcliffe Hospital. If your level of hypertension meets criteria for the Clinical Trial, your treatment will be free.