Heart specialists at Aga Khan University Hospital, Nairobi have performed the first key-hole operation to treat hypertension in the region. Hypertension (more commonly known as ‘high blood pressure’) is the most important preventable risk factor for premature death worldwide. The new operation which may have the potential to cure hypertension, or high blood pressure, was introduced in July by doctors at the Heart and Cancer Centre (HCC) of the Aga Khan University Hospital.
For the first time in Kenya, doctors used Renal Denervation Therapy on a patient with treatment-resistant hypertension.
Dr Mohamed Jeilan, Interventional Cardiologist and co-Director of Cardiac Services at the Aga Khan University Hospital, led the team of specialists who performed the ground-breaking operation explains, “Hypertension is an important disease and until recently, it could only be managed by taking regular medication. At the moment, medication is taken for life because the prospect of a definitive cure has been missing.
“It is now known that high blood pressure can be caused by faulty signals transmitted by hyperactive renal nerves between the brain and the kidneys. Renal denervation therapy is a treatment designed to silence these nerves and in so doing prevent high blood pressure.
“The treatment involves just one puncture incision on the right side of the groin. A thin and flexible tube called a catheter is introduced into the blood vessels which supply the kidneys. A small wire is passed into the blood vessel and carries enough energy to ‘freeze’ the nerves around the vessel.
“It takes about forty minutes to complete the treatment (twenty minutes for each kidney) and the patient is left with just one tiny scar. Research results published in The Lancet have shown that patients who had the procedure saw their blood pressure drop by around 20% with the blood pressure seeming to fall continuously even after two years. Renal denervation therapy may be among the most important developments in the care of heart patients in the last fifty years.”
Patients who have the new operation will not necessarily stop all their blood pressure medication, but should be able to take fewer tablets, reducing potential side-effects. At this stage, the operation is offered only to patients whose blood pressure is difficult to control although research is being carried out worldwide to explore the effects of this treatment on people with less severe hypertension.
Talking about hypertension Dr Jeilan added, “High blood pressure affects as many as thirty percent of East African adults. In most cases patients do not know that they have the condition; it is usually ‘silent’ and may go unnoticed.
In people with hypertension, the heart needs to work harder to send the blood around the body, and this eventually makes the heart weaker. The increased pressure also damages the walls of the blood vessels, and this can result in a haemorrhage or blockage, causing a stroke or heart attack. Having high blood pressure can double your chance of suffering from a heart attack or stroke and also put you at risk of kidney disease and visual impairment.
The chances of having high blood pressure increase with drinking excessive alcohol, or caffeine based drinks such as coffee and tea, eating a lot of salt, not eating enough fruit and vegetables, being overweight, not exercising regularly, smoking, having a family member with high blood pressure, or being of African descent.”
When first diagnosed, doctors will usually advise patients to adopt lifestyle changes such as cutting back on alcohol and salt. If this is not effective, medication is usually needed for life. Medications however do carry potential side-effects, including headaches, tiredness, cough, dizziness and impotence, which many patients struggle with. Medication is unable to control five to ten per cent of people with high blood pressure. Up until now, these patients have had no alternatives and have had to live with the risk of an imminent heart attack or stroke.