Published on 12:00 AM, March 16, 2013

Interview

Renal denervation to treat resistant hypertension

Schematic diagram of renal denervation procedure by radiofrequency ablation.

Heart disease is something that has got much developed in Bangladesh for the last few years due to many reasons. At the same time, the discipline is getting much more developments in the other parts of the world. Recently Dr Rohit Khurana, a Senior Consultant of Cardiology at the Gleneagles Hospital, Singapore visited Bangladesh and exchanged his views with Star Health about some recent updates in the treatment of heart disease.
Dr Khurana is trained in general cardiology and subspecialising in coronary intervention who is routinely performing complex angioplasty. Dr Khurana has a joint academic position as Assistant Professor at the Duke-NUS Graduate Medical School Singapore.
Dr Khurana says that there are increasingly new treatments for heart diseases like renal denervation. It is a novel treatment that is used to treat people having resistant hypertension. Whereas hypertension is very common among the elderly population (about 40-50%), resistant hypertension affects about 5-10% of individuals.
Now hypertensive patients are treated by four to five types of medicine to treat the long term risk of heart disease. But to treat the patients having truely difficult hypertension to treat by several types of medicine, renal denervation may be a good solution. The aim is to ablate the nerves in walls of kidney artery. The ablation helps in relaxation of the blood vessel and results in consistent improvement of blood pressure.
The response can sometimes be immediate and sometimes may delayed. Also some 10% do not respond to the treatment.
Renal denervation has multitude of benefits — it reduces the established risk factors for heart disease and stroke by a significant degree also reduced the number of drugs to control hypertension.
The procedure is very much similar to that of coronary angiogram/angioplasty that means a catheter is inserted through the femoral artery (a blood vessel in thigh) and by radio frequency ablation catheter slowly burns the nerves in artery wall. It takes about one and half an hour. It can be performed as a day case basis, although patients are advised to stay overnight just for monitoring. The procedure costs on an average SGD 18,000 as a package.
Dr Khurana is involved in the teaching of medical students and mentoring final year theses in Singapore. He showed interest to train local physicians if he is asked for.