Surgical treatment gives new hope to high blood pressure patients in the UAE

A new surgical treatment still under trial has been performed for the first time in Dubai at the American Hospital Dubai, giving new hope to sufferers of uncontrolled high blood pressure.

The first patient to undergo the procedure at the Hospital was a 56-year old male resident of the UAE, a US citizen of Jordanian origin.

High blood pressure – or hypertension - is one of the most common health issues facing the global community and the UAE, with around 30 per cent of the country’s population affected.

High blood pressure (BP) is associated with obesity and can lead to other potentially serious health issues, such as heart disease, kidney failure and stroke.

For many with high BP, advances in medication and lifestyle adjustments can help control the blood pressure to maintain a normal healthy life. For a significant number of others – around 10 per cent of all hypertension suffers – the problem cannot be controlled even through the use of multiple medications. This condition is known as Resistant Hypertension (RHT) and represents a serious health risk.

Until recently, there has been no treatment for RHT other than by using more medications in higher doses, with all the complications and side effects these may create and the adverse impact on the quality of life of the patient.

This may be about to change thanks to a new surgical treatment that is still under trial but which has just been performed for the first time in Dubai by the team at the American Hospital Dubai led by Dr. Omar Kamel Hallak, Chief Interventional Cardiologist, where special training and equipment allowed them to treat the first patient, with promising results.

One of the possible causes of resistant hypertension is thought to be due to miscommunication between the kidney and the brain through the ‘sympathetic nerve’ of the kidney, which plays a central role in the body’s ability to control blood pressure. Ablation (removing tissue) of the nerve improves the blood pressure control.

The new procedure – ‘Renal Nerve Ablation’ - was first trialled around three years ago and initial studies on a limited number of patients suggest that it is effective and safe, although there is not yet enough evidence to understand fully the long term effectiveness. This means that the procedure can only be carried out with special arrangements for clinical governance and the consent of the patient. Patient selection is critical and should be undertaken by a multidisciplinary team to establish that the patient cannot control blood pressure through medication or lifestyle changes.

Dubai’s first Renal Nerve Ablation patient was Mr Khalid Omari, a 56-year old senior manager at a construction company in Dubai, who had struggled with high blood pressure medications for around 12 years and had already had open heart surgery to unblock arteries.

“High blood pressure is a silent killer and once symptoms are apparent, it is often too late. I had suffered from headaches and knew something was not right. Following my heart surgery and after working with blood pressure medications with the team at the American Hospital Dubai, we had built a high level of trust; so, when we first discussed this new treatment, I researched the background carefully for several months and then agreed to the surgery. Recovery was fast and I certainly feel more energetic and motivated but we await the final outcome over the next three to six months. The worst case is no long term change to my condition but I can feel an immediate improvement and I hope to inspire others with high blood pressure to comply with their treatment and give hope to live a normal life.”    

The renal artery ablation procedure is undertaken using a special catheter (fine tube), which is connected to a generator which delivers low power radiofrequency energy and applies this to each renal artery at 4-6 points to ensure the nerve is severed. Dr Hallak - who has already designed a catheter used in renal artery stenting – has designed a new catheter to improve the performance of the current technology used in Renal Nerve Ablation, and which is currently under evaluation in the US.

“The immediate technical success rate of this new procedure is very high,” says Dr Omar Hallak, Chief Interventional Cardiologist at the American Hospital Dubai, who performed the first procedure.

“Based on patient studies, we know that it delivers an immediate short term average reduction in blood pressure, and that the blood pressure reduction is maintained at least over a two year period. This procedure appears to be very promising – it is not yet the standard of care but it will have significant applications in the future. The American Hospital Dubai is one of very few select centers in the world capable of performing the procedure, after extensive training and investment in new equipment, and the first procedure at the hospital went very smoothly and produced very good results for the patient.”

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