For decades, Michael Garrity battled dangerously high blood pressure that resisted every prescribed treatment. Then, a novel procedure targeting overactive nerves in his kidneys transformed his life.

“My blood pressure would spike, leaving me breathless and exhausted. That doesn’t happen anymore,” said Garrity, 62, from Needham, Massachusetts. Now, with lower medication doses and normal blood pressure for the first time in years, Garrity says, “I’m thrilled.”

His story highlights the promise of renal denervation, a minimally invasive procedure recently approved by the FDA and endorsed by the American Heart Association as a promising option for patients with treatment-resistant hypertension.

Understanding High Blood Pressure

Hypertension affects about half of U.S. adults, often silently increasing risks for heart attack, stroke, kidney failure, and even dementia. Blood pressure is measured by two numbers:

  • Systolic pressure: The force of blood against artery walls when the heart beats.
  • Diastolic pressure: The force when the heart rests between beats.

Normal blood pressure is below 120/80, but consistent readings above 130/80 signal hypertension, which stiffens arteries and forces the heart to work harder.

“Know your numbers,” advises Dr. Randy Zusman of Massachusetts General Hospital. “Unchecked hypertension can cause serious damage before you notice symptoms.”

Traditional Treatments

Lifestyle changes, including exercise, weight loss, and a heart-healthy diet, are the first line of defense. But for many patients, medication becomes essential. Managing severe hypertension often requires two or more drugs, and even then, some cases—like Garrity’s—remain resistant to treatment.

What Is Renal Denervation?

Renal denervation offers a new approach for those struggling with uncontrolled hypertension. During the procedure:

  • A catheter is threaded through blood vessels to the kidneys.
  • Ultrasound or radiofrequency energy targets nerves surrounding the renal arteries.

These nerves help regulate blood pressure, and by disrupting their signals, the procedure can lower blood pressure by an average of 8 to 10 points. Some patients, like Garrity, experience even greater reductions, allowing them to decrease medication use.

“It’s not a cure,” cautions Dr. Joseph Garasic, the Mass General cardiologist who performed Garrity’s procedure. “But for carefully selected patients, it offers a meaningful improvement.”

A Long Road to FDA Approval

Renal denervation faced setbacks before gaining FDA approval in November 2023. A key trial a decade ago failed, prompting researchers to refine their methods. Today, two catheter systems—developed by Recor Medical and Medtronic—are approved, with safety protocols ensuring patients with kidney disease or narrowed arteries are excluded from the procedure.

While studies show short-term safety and efficacy, long-term outcomes remain unknown, particularly whether the nerves may regenerate over time.

Who Is a Candidate?

Renal denervation is currently recommended for patients whose blood pressure remains high despite taking multiple medications. However, careful evaluation is essential.

The American Heart Association urges patients to discuss the procedure thoroughly with experienced physicians to determine if they’re good candidates. Factors like kidney health, medication response, and overall heart health play a role in eligibility.

The Path Forward

Renal denervation represents a significant step forward in managing treatment-resistant hypertension. While not a cure-all, it offers hope to patients who’ve exhausted other options, potentially improving quality of life and reducing the risks of severe complications.

“Know your blood pressure, monitor it regularly, and explore all your options,” Dr. Zusman advises. For patients like Garrity, this innovative procedure could mean the difference between struggling and thriving.