Issue link: https://viewer.e-digitaledition.com/i/79506
RECENT RESEARCH Clinical Trial Investigates If Denervating Kidney Nerves Reduces Blood Pressure Can high blood pressure be safely reduced and controlled by "disconnect- ing" nerves in the kidneys? That is a question that a new clinical study called Symplicity HTN-3 at University Hospitals Case Medical Center (UHCMC) hopes to answer. The study will enroll people who have resistant hypertension, meaning that their blood pressure remains extremely high despite taking three or more medica- tions. UH is a clinical site for the five-year national study funded by Medtronic and is one of 90 sites in the nation that will enroll more than 500 people with high blood pressure resistant to medical therapy into the study. It will involve a novel multi-disciplinary approach to hypertension treatment using cardiac and kidney specialists. In the Symplicity HTN-3 clinical study, research subjects will be randomly assigned to one of two groups: One-third will continue the best available medical treatment and two-thirds will combine the best available medical treatment with a procedure where participants will have the nerves in their renal arteries disrupted with radio frequency energy that generates heat. The process is called renal denervation. An earlier study (Symplicity HTN-2), performed in Europe and Australia, found that patients who underwent renal denervation experienced a nearly 30mmHg of systolic blood pressure reduction compared to treatment with medications alone. Symplicity HTN-3 will be a much larger trial conducted entirely in the US. The denervation of the kidney arter- ies will be performed in the cardiac catheterization lab. The procedure itself takes about 45 minutes and involves using low level radio frequency energy to heat the tissue in the renal artery just enough to eliminate the nerves without hurting the arterial wall. Patients generally experience minimal discomfort during the procedure. So far, long-term side effects have been minimal in the patients treated in Europe and Australia. The study is current ly enrol l- ing patients 18 to 80 years old. For more information about enrollment criteria, visit ClinicalTrials.gov, study identifier: NCT01418261. Study Finds Soda Consumption Increases Overall Stroke Risk Researchers from Cleveland Clinic's Wellness Institute and Harvard University have found that greater consumption of sugar-sweetened and low-calorie sodas is associated with a higher risk of stroke. Conversely, consumption of caffeinated or decaffeinated coffee was associated with a lower risk. The study, recently published in the American Journal of Clinical Nutrition, is the first to examine soda's affect on stroke risk. Previous research has linked sugar-sweetened beverage consumption with weight gain, diabetes, high blood pressure, high cholesterol, gout and coronary artery disease. The research analyzed soda consump- tion among 43,371 men who participated in the Health Professionals Follow-Up 12 | Cleveland-Akron-Canton MD NEWS ■ MDNEWS.COM ■ SEPTEMBER-OCTOBER 2012 Study between 1986 and 2008, and 84,085 women who participated in the Nurses' Health Study between 1980 and 2008. During that time, 2,938 strokes were documented in women while 1,416 strokes were documented in men. In sugar-sweetened sodas, the sugar load may lead to rapid increases in blood glucose and insulin which, over time, may lead to glucose intolerance, insulin resistance, and inflammation. These physiologic changes influence atherosclerosis, plaque stability and thrombosis — all of which are risk factors of ischemic stroke. This risk for stroke appears higher in women than in men. In comparison, coffee contains chlo- rogenic acids, lignans and magnesium, all of which act as antioxidants and may reduce stroke risk. When compared with one serving of sugar-sweetened soda, one serving of decaffeinated coffee was associated with a 10 percent lower risk of stroke. In addition, study findings show that men and women who consumed more than one serving of sugar-sweetened soda per day had higher rates of high blood pressure and high blood cholesterol and lower physical activity rates. Those who drank soda more frequently were also more likely to eat red meat and whole-fat dairy products. Men and women who consumed low-calorie soda had a higher incidence of chronic disease and a higher body mass index (BMI). The investigators controlled for these other factors in their analysis to determine the independent association of soda consumption on stroke risk. ■