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Docs to try new hypertension treatment

WASHINGTON -- Hypertension may be the nation's sneakiest epidemic, a leading time bomb for heart attacks, strokes and kidney failure, and one that's growing worse as the population rapidly grows older.

Despite an arsenal of drugs, millions of people in the United States can't get their blood pressure down to safe levels.

Now, in a high-stakes experiment, hospital scientists are testing a dramatically different approach for the toughest to treat patients, by burning away some overactive nerves deep in the body that can fuel blood pressure.

To attempt an invasive treatment -- a catheter is threaded through blood vessels in the groin up to the kidneys -- reflects doctors' frustration with a disease that too often is underrated because people with it don't look or feel sick until damage has been done.

Researchers increasingly are trying medical devices and minimally invasive surgeries, such as stomach-shrinking techniques that improve obesity-caused diabetes and the new hypertension experiment.

"I think we have to hit on all cylinders if we're going to take on these very important diseases," said Dr. Steven Nissen, chairman of the Cleveland Clinic's department of cardiology. "You push the drugs as far as you can, but when they can't go any further, you step in with more invasive approaches."

Cardiologists' interest in the nerve-zapping procedure also reflects how severe the burden of hypertension is poised to become, with many middle-aged boomers already affected.

"If there was a snake in the room, all of our blood pressures would go up, appropriately so," said cardiologist Dr. Manesh Patel of Duke University, one of more than 60 U.S. medical centers studying Medtronic Inc.'s nerve-zapping procedure.

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Sometimes those nerves stay switched on when they shouldn't be, which today's medications can't address. The hope is that destroying a small number of the nerves could calm an overactive system, relaxing arteries and lowering blood pressure.

Some 78 million people in the country, about 1 in 3 adults, have high blood pressure, meaning readings of 140 over 90 or higher. An additional 27 million people will have it by 2030, says a grim forecast from the American Heart Association.

Only about half of patients have their hypertension under control. Some 10 percent, more than 7 million people, have the resistant hypertension that is the initial target of the nerve-zapping procedure -- people with high blood pressure despite three or more different kinds of medications.

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