Virtua Health is the first in New Jersey to perform an innovative new procedure designed to help people with uncontrolled high blood pressure. Recently approved by the U.S. Food and Drug Administration (FDA), the Medtronic Symplicity Spyral™ renal denervation system uses radiofrequency energy to treat overactive nerves on the outer surface of the kidney arteries. This minimally invasive procedure is clinically proven to help reduce high blood pressure^1-3 and offers new hope to individuals whose previous efforts with medication and lifestyle changes did not have the desired result.

High blood pressure, also known as hypertension, is the single largest contributor to death,⁴ and affects about 50% of U.S. adults.⁵ Of the U.S. adults who are aware of their hypertension, about 80% do not have it under control.⁶

“Many consider this the first significant innovation for treating high blood pressure in nearly 30 years,” said Virtua interventional cardiologist Kintur Sanghvi, MD, FACC, FSCAI, who performed the health system’s first Symplicity procedure at Virtua Mount Holly Hospital on January 9. Throughout his career, Dr. Sanghvi participated as primary investigator in multiple landmark clinical trials investigating renal denervation.

Brain-Kidney Connection
Much like how the electrical wiring in a house provides power to appliances, the brain has a complex network of nerves that control the organs. The sympathetic nervous system—best known for its part in the body’s “fight-or-flight” response—tells the kidneys how blood pressure should be regulated. People with hypertension have an overactive sympathetic nervous system, which keeps blood pressure high.

“For some of my patients, their fight-or-flight response is constantly overactive,” said Dr. Sanghvi. “By taking out this hyperactive nerve response, we can reduce blood pressure to a healthier range.”

Disrupting the Nerves
During the Symplicity procedure, Dr. Sanghvi makes a small needle puncture in the groin artery, inserts a wire and catheter, and threads them to the kidney arteries. The catheter then emits radiofrequency energy that disrupts the sympathetic nerves that lie just outside the walls of the kidney arteries. The arteries themselves are not harmed during the process.

The catheter and wire are then removed from the body. Patients will spend, on average, four to six hours in the hospital before returning home.

“Through this procedure, we tone down the overactive sympathetic nerve activity, the cause of high blood pressure, which over the next several months translates into lower blood pressure,” said Dr. Sanghvi. “While this treatment does not replace a healthy lifestyle or medication, it is an adjunct to achieve blood pressure control. In clinical trials, some patients controlled their blood pressure with fewer or no medications following this treatment.”

A New Option for Patients
Candidates for the procedure include those who have:

• Blood pressure higher than 130/80 mmHg despite taking three or more medications for blood pressure
• Uncontrolled high blood pressure, despite trying lifestyle measures and medications
• Uncontrolled hypertension along with other heart or vascular disease, diabetes, or a prior history of heart attack or stroke

“By lowering your blood pressure by 5 to 10 millimeters, we can reduce your risk of a cardiovascular event by 10% to 30%,” said Dr. Sanghvi. “We are excited to offer this game-changing procedure to patients.”

To learn more about Virtua Health’s comprehensive care offerings, visit virtua.org or call 888-847-8823.

1. Sources:
   Kandzari DE, Böhm M, Mahfoud F, et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. The Lancet. 2018 Jun 9;391(10137):2346-2355. 
2. Böhm M, Kario K, Kandzari DE, et al. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomized, sham-controlled trial. The Lancet 2020; Published online March 29, 2020. DOI: 10.1016/S0140-6736(20)30554-7. 
3. Townsend RR, Mahfoud F, Kandzari DE, et al. Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial. The Lancet. 2017;390:2160–2170. 
4. WHO. Hypertension fact sheet. September 13, 2019. Available at: https://www.who.int/news-room/fact-sheets/detail/hypertension. Accessed February 15, 2022. 2. Kandzari DE, Böhm M, Mahfoud F, et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial. The Lancet. 2018 Jun 9;391(10137):2346-2355. 
5. U.S. Department of Health and Human Services. The Surgeon General’s Call to Action to Control Hypertension. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General; 2020. 
6. Facts about Hypertension. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/bloodpressure/facts.htm. Accessed August 10, 2023.