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Treating hypertension with help of the ultrasonic device.

Treating hypertension with help of the ultrasonic device.

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Introduction

The findings of a recent meta-analysis of prior studies looking into a novel method of blood pressure control seem promising. It explains a treatment that “mutes” overactive kidney nerves, a sign of hypertension frequently observed in middle-aged adults.

Participants’ blood pressure was dramatically reduced after the procedure, dropping by an average of 8.5 millimeters of mercury (mmHg). Follow-ups two months later and three years later supported the effectiveness of this advantage.

One of the primary causes of death on a global scale is hypertension or high blood pressure. In addition to heart, brain, and renal disorders, it can cause strokes. Since an estimated 46% of people with hypertension are unaware that they have it, it is frequently referred to as the “silent killer”.

Many hypertension medications, may be helpful in addition to a healthy lifestyle and dietary adjustments in managing the illness. Many folks find this to be adequate. Nonetheless, some people’s blood pressure continues to be consistently high.

Reports

According to a recent meta-analysis, the 506 hypertensive participants in three randomized clinical trials had considerably lower blood pressure when therapeutic ultrasonography was used to reduce kidney-nerve hyperactivity.

The exact etiology of hypertension is unknown. Scientists speculate that it may be a result of a mix of genetics, lifestyle, aging, and other processes.

Middle-aged hypertension is typically accompanied by hyperactive renal nerves, which can raise blood pressure in several different ways. It could cause salt and water retention as well as the production of hormones that raise blood pressure.

Even though there are many different medications for treating hypertension, none explicitly target this renal overactivity. So, the “renal denervation” ultrasound approach investigated in the present study provides clinicians with an extra instrument. Thi was made to support patients in maintaining their health.

Researchers from the Université de Paris in France and Columbia University in New York City carried out the study. You can find it in JAMA Cardiology.

How blood pressure is measured?

Millimeters of mercury, or mmHg, is used to measure blood pressure. This is because early precise blood pressure gauges and some contemporary systems rely on mercury.

Two blood pressure readings are usually displayed, one above the other or to the left of the other. Systolic blood pressure, or the pressure the heart puts off when pumping blood, is the first value. The pressure in arteries between heartbeats is shown by the second value, called the diastolic value.

The American Heart Association defines good blood pressure as having a systolic reading of less than 120 mmHg over a diastolic reading of less than 80 mmHG. A value of 130–139/80–89 mmHG indicates stage 1 hypertension. Higher results indicate hypertension in stage 2.

The current study discovered that renal denervation dramatically decreased participants’ blood pressure, by 5 to 10 mmHG, with an average decrease of 8.5 mmHg.

kidney nerves and high blood pressure

It is believed that overactive renal nerves induce water and sodium retention and produce hormones that can elevate blood pressure. They are a contributing factor in the development of hypertension in middle age. As blood arteries stiffen in older adults, hypertension frequently develops.

Antihypertensive medications lower blood pressure in a variety of methods, such as by dilation of blood vessels, removal of extra fluid, or blockage of hormones that elevate blood pressure. Yet, none of these drugs specifically target the renal nerves.

By calming hyperactive nerves in the renal artery, ultrasound treatment blocks the signals that cause hypertension. A thin catheter that is placed into a vein in the wrist or leg and sent to the kidney delivers the therapy to the nerves.

Renal denervation

A tiny catheter that is placed into a vein in the leg or wrist and threaded into the kidney makes up the renal denervation device addressed in the study. During the operation, ultra-high-frequency sound waves are used to treat the kidney’s nerves. This causes minute amounts of scar tissue to form, which reduces the nerve activity. “Ablation” is the name of this procedure.

Lead author Dr. Ajay J. Kirtaine predicted that the surgery would be performed as an outpatient, similar to cardiac catheterization.

“Ultrasound-renal denervation’s ablation portion is less than one minute, and the whole procedure is less than an hour, with conscious sedation/local anesthetic,” he said.

In the research, participants were divided into two groups: the ultrasound denervation group and the control group, which had a sham operation with no therapeutic benefit.

The number of participants in the study arm who received the therapy to lower blood pressure to 135/85 was twice as high. This outcome was the same in all three investigations, which included a population of different racial backgrounds, indicating the technique is probably valuable to many people.

The investigations indicated that the reduction in blood pressure persisted for at least 2 months following the operation and that participants’ blood pressure was improved. The result of the surgery “appears to be durable with follow-up out to 3 years,” according to Dr. Kirtaine.

Not yet, at least not for everyone.

The device is experimental so far, having not acquired permission for usage in the United States. The study’s authors plan to apply it to people whose blood pressure is still uncontrolled despite modifying their lifestyles and taking medication.

Dr. Jayne Morgan, a cardiologist who was not involved in the study, concurred and viewed the procedure as perhaps a secondary treatment rather than a first-choice therapy. But she noted, “I envision that this might certainly be reversed in the future with continued trials and information/data.

According to Dr. Morgan, the surgery may be especially beneficial for Black people and other minorities who have high rates of hypertension and heart disease.

This is a terrific reason why Black volunteers should be recruited, she said, since it may offer a more long-lasting option for blood pressure control in the future. 17% of participants in the meta-analysis were Black Americans.

Dr. Devin Kehl, who was not involved in the research, issued a warning: “The trials have been quite limiting in their inclusion and exclusion criteria,” despite the fact that the technique has an outstanding long-term safety profile and is probably safe.

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Are the eyes the window to our health condition?

Are the eyes the window to our health condition?

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Diabetes, multiple sclerosis, and even Alzheimer’s disease can all be identified simply looking into someone’s eyes. Most people have their eyes checked periodically. However,few may be aware that an eye exam is used for more than simply vision correction and vision testing.

The eye is the only organ in the body that allows for a non-invasive examination of the inside by medical professionals due to its frontal “window.” The retina, which is located at the back of the eye, is where blood vessels and the optic nerve are visible in detail.

An optometrist may refer a patient to a medical ophthalmologist if a normal eye exam causes them to have concerns. The medical ophthalmologist will further investigate by doing additional eye exams. If the results of their examinations point to a systemic disease, doctors can then refer the patient to the appropriate expert.

What can be diagnosed?

A routine eye exam can discover vision issues including nearsightedness, farsightedness, and astigmatism. Also, other eye conditions like glaucoma and age-related macular degeneration. The optometrist can learn a lot about a person’s general health by checking the blood vessels in the retina and the optic nerve.

This non-invasive method can identify a wide range of medical illnesses. This includes hypertension, diabetes, thyroid issues, neurodegenerative diseases like Alzheimer’s and multiple sclerosis, and hypertension that may not be immediately apparent to the eyes (MS).

“Ocular inflammation can damage a variety of eye structures and is frequently the initial symptom of a systemic illness. According to Dr. Ibrahim, concentrated history-taking and a guided evaluation of the pertinent physiological systems, including blood testing, are the keys to determining the cause.

Eye Exams and Your Health

Doctors can identify general health concerns early enough to intervene with the use of eye examinations. With the use of advanced tests, ophthalmologists can more accurately forecast cardiovascular events. This includes stroke and perhaps spot early indications of mental deterioration like Alzheimer’s. Learn how eye exams can reveal much more than simply eye health by reading the information below.

Brain tumours and stroke

Because the blood vessels in the brain and eyes are similar, an eye doctor may occasionally be able to identify a problem with the brain by looking at the blood vessels in the eyes. If swelling or shadows are noticed in the eye, this could be a sign of a dangerous brain problem. This includes a tumour or blood clots that could cause a stroke.

Diabetes

Diabetic Retinopathy (DR) and diabetic macular edoema are conditions where diabetes has damaged the blood vessels in the retina at the back of the eye (DME). In order to help control their blood sugar, the patient would be encouraged to consult a doctor if an optometrist discovered leaky blood vessels in their eyes. The slow changes begin before any visible symptoms are seen. The likelihood of maintaining vision improves with earlier management of diabetic eye illness.

Hypertension

An eye exam can identify high blood pressure, which is characterised by excessive blood vessel pressure. Sometimes even before your regular doctor makes the diagnosis. You can see swelling, haemorrhages, and leakage in the eyes as a result of the blood vessels that are injured. The CDC claims that approximately one in three adults have hypertension, known as “the silent killer,” and that up to 20% of those people are unaware of their condition. Thus, early diagnosis during an eye doctor’s evaluation can actually save lives.

High Cholesterol

Exams of the eyes might also spot cholesterol accumulation. One of the simplest illnesses to diagnose during a thorough eye exam is high cholesterol. Since the deposits of the disease show up on the front of the eye as a thin, grey rim surrounding the cornea. By analysing artery and vein patterns, it can also be found in the retina.

Retinal Blood Vessel Occlusion is a condition in which blockages limit blood flow to the back of the eye. This leads to temporary or permanent vision loss. These deposits may be an indication of the current or future development of this condition.

Heart Problems

Certain heart disorders that cause the carotid artery in the heart to accumulate plaque can also result in deposits that obstruct the ocular arteries in the eyes. An optometrist would often advise consulting a specialist if they notice these modifications to the vascular system at the back of the eye.

Several Sclerosis (MS)

Multiple Sclerosis may be to blame for sudden visual loss (MS). While the colour and appearance of the optic nerve are indicators of MS that the optometrist can detect, such instances will be sent for additional testing to confirm the diagnosis.

Thyroid

There are various ways that thyroid disease can manifest in the eyes. Certain thyroid abnormalities can lead to dry eye illness because the thyroid gland regulates the hormones that influence tear production. Furthermore, hyperthyroidism, an overactive thyroid condition, can cause the extraocular muscles to expand and stiffen, resulting in bulging eyes, a sign of Graves’ disease.

Inflammation

The eyes may become inflamed as a result of systemic illnesses that are linked to inflammation in the body. For instance, uveitis, which can result in eye inflammation, redness, and blurred vision, is more common in patients with autoimmune illnesses including lupus, rheumatoid arthritis, and others.

Cancer

An eye exam can occasionally reveal metastatic malignancies like breast cancer, leukaemia, and other types of cancer. Eye specialists can also diagnose lymphoma and other eye cancers in addition to the previously stated brain cancer, basal cell carcinoma and melanoma (skin cancer), which can also be diagnosed. A good eye check saves lives.

REFERENCES:

  • https://www.medicalnewstoday.com/articles/biking-vs-running-2
  • https://www.brightfocus.org/glaucoma/article/eye-window-your-health
  • https://health.clevelandclinic.org/your-eyes-a-window-to-your-health/
  • https://www.eyecaredoctors.com/2019/12/22/eyes-are-windows-to-your-health-2019/

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