Deep Brain Stimulation May Control Hard-to-Treat Blood Pressure

Rachael Rettner, MyHealthNewsDaily Staff Writer

Date: 24 January 2011 Time: 03:01 PM ET

Deep brain stimulation may have benefits beyond the treatment of brain disorders it may provide an alternative therapy for people with high blood pressure patients who aren't able to treat their condition with drugs, according to a new study.

The report describes the case of a 55-year-old man who underwent deep brain stimulation which uses a surgically implanted device to send electrical pulses into the brain as treatment for chronic pain. The man also had high blood pressure, or hypertension , which had stayed elevated despite previous treatments, including being medicated with four prescription drugs simultaneously.

Though the deep brain stimulation did little to treat the patient's pain, it lowered his blood pressure enough for him to quit taking his blood pressure medications for nearly three years, the researchers said.

While the findings are preliminary, and require validation in a larger number of patients, they are exciting, said William T. Abraham, director of the division of cardiovascular medicine at The Ohio State University Medical Center, who was not involved in the study.

"I wouldn't see this as a routine treatment for patients with mild or moderate hypertension," Abraham said. But "certainly, for those patients with severe or refractory hypertension, it might be an alternative," he said.

Deep brain stimulation may seem like an extreme procedure to treat a condition like high blood pressure . But experts say that's not necessarily the case.

"The consequences of not lowering the blood pressure in those patients are really very severe," Abraham said.

"They have strokes, they have heart attacks , they develop end-stage kidney failure and spend the rest of their life on dialysis." When you consider those consequences, "something that on the surface sounds extreme implanting a deep brain stimulator doesn't sound quite so extreme anymore," he told MyHealthNewsDaily.

In the study, researchers at Frenchay Hospital in Bristol, England, implanted a stimulator in a brain region involved in pain regulation. The patient experienced a gradual decline in his blood pressure soon after deep brain stimulation began.

When the device was switched off after about two years, the patient's blood pressure went back up. When it was switched back on, his blood pressure went down again. The researchers saw the same result when they repeated these tests.

The results agree with earlier work showing treatments that target the body's sympathetic nervous system, which produces our "fight or flight" response, can lower blood pressure, the researchers said.

An overactive sympathetic nervous system has been implicated in high blood pressure, Abraham said. Some hypertension drugs aim to decrease the system's activity, but are likely not enough for some patients.

Abraham's prior research has involved targeting the sympathetic nervous system in different ways, including one procedure that blocks activation of nerves in the kidneys thought to contribute to high blood pressure.

"The common thread here is using procedures or devices to turn down the sympatric nervous system to lower blood pressure in these patients," Abraham said.

"The good news is, it looks like a variety of approaches, all of them preliminary, all of them still investigational...might be helpful here," he said.

About 70 million people in the United States suffer from high blood pressure, Abraham said, and some 10 to 20 percent of cases are resistant to treatment. Because some procedures required to treat the consequences of unchecked high blood pressure, such as dialysis for those with kidney failure, are quite costly, "the economic cost to the health care system is really quite enormous," he said. This cost is another reason to consider alternatives such as deep brain simulation.

In addition, the technologies involved in using deep brain stimulation have matured over the past decade, Abraham said.

The study will be published Jan. 25 in the journal Neurology.

Pass it on: Deep brain stimulation might treat people with high blood pressure whose condition has not responded to drug treatments. However, the results need to be replicated in a larger number of patients.

Follow MyHealthNewsDaily staff writer Rachael Rettner on Twitter @Rachael_MHND.