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Patients with treatment-resistant hypertension have high blood pressure that remains greater than 140/90 mmHg, despite treatment with three or more antihypertensive medications.

Renal denervation uses a tiny device threaded into the renal arteries to deactivate nerves to the kidneys. Once in place, the tip of the catheter delivers low-power, radio-frequency energy to modulate the surrounding sympathetic nerves. When overactive, these nerves can raise blood pressure and contribute to heart, kidney and blood vessel damage.

?Renal denervation and ongoing treatment with antihypertensive medications have the potential to help patients achieve their target blood pressure levels,? said Mark Robbins, M.D., assistant professor of Medicine and co-principal investigator of the trial with Jay Gainer, M.D., chief of the Vanderbilt Hypertension Center.

The clinical trial, known as SYMPLICITY HTN-3, is a randomized, controlled trial designed to evaluate the safety and effectiveness of the Symplicity Renal Denervation System and will enroll about 530 patients at more than 60 medical centers.

The Symplicity Renal Denervation System has been successfully used since 2007 to treat more than 2,000 patients worldwide and has been commercially available in Europe and Australia since 2010.

The system is not approved by the U.S. Food and Drug Administration (FDA) for commercial distribution in the United States.

?We?ve had multiple types of drugs around for the treatment of patients with refractory hypertension, but no significant improvement in care of these patients has been as effective as the results of initial Symplicity trials,? Robbins said. ?What we?ve seen is a marked improvement in blood pressure management.?

?If the success of this procedure in the initial trials can be replicated in the United States, this therapy could be quite a breakthrough for a significant proportion of patients who chronically require four or more blood pressure medications to establish acceptable BP control,? Gainer said.

More information: The trial is currently enrolling patients. Contact study coordinator Sean Johnson for more information.

Provided by Vanderbilt Medical Center

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AT THE two ends of the timeline for the recent changes at West Cornwall Hospital are the renal unit and the shiny new treatment centre.

While the treatment centre has only just opened, the renal unit was refurbished in March last year.

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   Adrian Evans runs the new Treatment Centre at West Cornwall Hospital

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   Adrian Evans, ward manager at the new treatment centre at West Cornwall Hospital.

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   Percy Miles, from Carbis Bay, with Renal Unit manager Carole Gardner and dialysis technician Yvonne Olds.

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   Percy Miles, from Carbis Bay, with Renal Unit manager Carole Gardner and dialysis technician Yvonne Olds.

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   Inside the operating theatre at West Cornwall Hospital. Included are Mr Siva Gopalswamy, consultant laparoscopic surgeon; Dr David Elliott, consultant anaesthetist; Kate Hales, theatre manager; Debbie Moon, scrub nurse; Alana Elsworth, theatre assistant and Debbie Middleditch, student ODP.

Sister Carole Gardner runs the unit where people in need of blood dialysis come in three times a week.

She said: "We were the first of the round of changes in March last year and it has dramatically increased our capacity.

"We were opened in 1996 with five dialysis machines and now we have ten, which builds in capacity for the future.

"And we have an isolation bay now so that we can give dialysis to anyone who has a bug or needs to be kept separate and that means they don't have to go 'up the road'."

Not up the road, but on the other side of the St Clare site, is the swanky new treatment centre.

The custom-built centre has different things happening on different days, to get the most out of the building and the equipment in it.

It is involved in various areas, from endoscopy – essentially sticking cameras into people – and other diagnostic procedures, to varicose vein treatment to pain clinics, where the exact source of pain is identified and then physiotherapists and anaesthetists tackle it at the root.

Wet Age-related Macular Degeneration (WARM) treatment sees 50 patients a week assessed and then treated, which can include an injection in the eye, to help stop people going blind.

Adrian Evans, ward manager, said: "We're really building up what's happening here. We knew it would take time for things here to fit in properly.

"Patients have a great experience, it's a nice environment, it's bright and airy and it helps people to be more relaxed.

"I've been here 16 years and I can remember when this was the day case ward.

"Although the public were really concerned about services changing here, we are actually doing a lot more surgery here.

"There has been a principle that any change is bad and we've seen that people will march for the hospital. But we have to be realistic about what we can provide here. It's important to realise there's a lot going on.

"And we're still here. We still get people saying 'don't close this place'.

"In my 16 years I've never heard any suggestion that we were going to. It was purely because services were changing and a lot of that had nothing to do with RCHT – it was nationwide.

"The laparascopic theatre doesn't mean more complex surgery, it means a much better and more efficient way of doing what we do."

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