The $1.2 million nationwide project, funded by the new HRC/National Health Committee Heart Innovation Partnership and led from the National Institute for Health Innovation at the University of Auckland, will evaluate how the care for people with resistant high blood pressure can be improved in New Zealand.
The two year project that starts in February next year will compare the effectiveness of a comprehensive clinical management approach with a new treatment that ‘zaps’ nerves to the kidney to reduce blood pressure.
Heart health researchers from the University of Auckland, led by principal investigator Professor Rob Doughty, will work with a team of leading health professionals from across the country. The trial, supported by five district health boards, will include several hundred people with resistant high blood pressure from throughout Auckland, Waikato and Christchurch.
The trial – within a wider programme of work – will compare the effects of renal denervation to those of intensive medical management on blood pressure and other measures of health.
It will be clinically led, with strong participation from medical and interventional specialists and general practitioners.
High blood pressure (“hypertension”) affects at least one in four New Zealand adults. Over many years this can increase their risk of heart attack, stroke, heart failure, or kidney disease. Treating hypertension has been consistently shown to reduce the risk of cardiovascular disease and stroke, which are major health targets in New Zealand.
Although high blood pressure disease can be treated with lifestyle changes and prescription medication, for the estimated two to four per cent of people with resistant hypertension, these steps alone aren’t enough.
Resistant high blood pressure is defined as having a systolic blood pressure greater or equal to 160mmHg despite taking at least three blood pressure lowering medications. Normal blood pressure is less than 120mmHg (systolic) and less than 80mmHg (diastolic).
People with resistant high blood pressure need quite intensive help to lower their blood pressure. Lifestyle changes, including reducing salt intake and losing weight, along with combinations of tablet treatment can help some people.
The renal denervation procedure involves passing a tube from the groin artery to the renal artery and quietening the sympathetic nerves to the kidney by “zapping” them with radiofrequency energy.
This simple catheter procedure can markedly reduce blood pressure.
New Zealand Chair of the Cardiac Society of Australia and New Zealand Professor Ralph Stewart says renal denervation is a very promising technique, but its role in New Zealand health care is currently uncertain. Renal denervation is still new in this country and is only available in certain centres.
The Health Innovation Partnership was established earlier this year between the National Health Committee and the Health Research Council of New Zealand.
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