 "Silent killer alert: Nearly 20 cr Indians have high BP, renal denervation therapy offers new hope")
With nearly 20 crore adults in India estimated to be living with hypertension and only about 2 crores managing to keep it under control, the condition has emerged as one of the country’s most pressing public health concerns.
Medical experts have warned of the rising prevalence of resistant hypertension and highlighted the role of renal denervation (RDN), an advanced therapy showing promising results in managing uncontrolled cases.
A growing health concerns
Data from the National Family Health Survey (NFHS) shows that hypertension prevalence ranges from 16% to over 25% in some states, with urban areas reporting a higher share of patients whose blood pressure remains uncontrolled despite treatment.
In Delhi, prevalence is estimated at 28%. Experts note that about 5–10% of hypertensive patients in India may suffer from resistant hypertension, defined as persistently high blood pressure (≥150 mmHg) despite lifestyle measures and treatment with three or more antihypertensive drugs.
Resistant hypertension can progress gradually, presenting with symptoms such as frequent headaches, dizziness, breathlessness or chest discomfort. Over time, persistently elevated blood pressure places sustained strain on the cardiovascular system and other vital organs. Studies show that lowering systolic blood pressure by just 10 mmHg can reduce the risk of heart disease by 20% and stroke by 27%.
What is Resistant hypertension
Resistant hypertension defined as persistently high blood pressure (≥150 mmHg) despite lifestyle measures and treatment with three or more antihypertensive drugs is an under-recognized contributor to this challenge, affecting patients’ long-term health and wellbeing. As per National Family Health Survey – 5, hypertension prevalence in Delhi is estimated to be 28%. Estimated 5-10 % of hypertensive patients in India are resistant, based on clinical practice.
Resistant hypertension may progress gradually, with symptoms such as frequent headaches, dizziness, breathlessness, or occasional chest discomfort. Over time, persistently elevated blood pressure places sustained strain on the cardiovascular system and other vital organs. Average BP reduction seen in patients treated in clinic; observed improvement in cardiovascular risk profile. Clinical studies show that lowering systolic blood pressure by just 10 mmHg can reduce the risk of heart disease by 20% and stroke by 27%.
25 per cent average BP reduction with Renal Denervation
Dr Praveen Chandra, Chairman, Cardiology, Medanta (The Medicity) said “While antihypertensive medicines are highly effective for many, control remains difficult for a significant number of patients. When patients understand their condition and the options available, they are better equipped to take control of their health and work with their doctors towards better outcomes.”
Renal Denervation: Hypertension solution
Renal Denervation is an advanced therapy that is minimally invasive, catheter-based procedure that addresses one of the underlying drivers of hypertension, overactive nerve signals between the brain and kidneys, Dr Chandra said, adding that by interrupting these signals, RDN helps lower and stabilise blood pressure over time.
“As per my experience, till date; 25% average BP reduction has been achieved in these patients; with a significant reduction seen in medication load post-procedure.”
Hypertension and kidney disease closely linked
“Uncontrolled hypertension is associated with multiple risk factors, including chronic kidney disease. Hypertension is very common in patients with CKD and CKD is the most important cause of resistant hypertension. Uncontrolled hypertension can cause rapid progression of kidney disease leading to kidney failure,” said Dr Shyam Bansal, Vice Chairman, Institute of Nephrology & Kidney Transplant, Medanta.
“In such cases, advanced therapies such as renal denervation can revolutionize treatment for resistant hypertension, allowing patients to take control of their health. Clinical evidence shows sustained BP reduction for 3+ years across varied patient groups; effectiveness in patients with chronic kidney disease, diabetes, and other co-morbidities and potential to reduce reliance on multiple medications and improve quality of life,” Dr Bansal added.
Impact Shorts
More ShortsRDN shows promise in hypertension treatment
Recent clinical experiences with RDN show promising results, with reductions in blood pressure ranging between 40–45 mmHg systolic and 15–20 mmHg diastolic across diverse patient groups. Many had histories of stroke or chronic kidney disease, where hypertension was accelerating decline in kidney function. Following the procedure, their eGFR levels remained stable during 9–12 months of follow-up.
The broader benefits of blood pressure reduction are also striking. Lowering systolic BP by just 10 mmHg is linked to a 27% reduction in stroke risk, 28% in heart failure, and 17% in coronary artery disease. Patients undergoing RDN also reported a meaningful drop in medication dependence from an average of 5 drugs to just over 3, easing side effects and improving adherence.
Baseline office BP levels in many cases averaged 186/99 mmHg, with patients experiencing nearly a 50 mmHg drop in systolic BP at discharge, and sustained improvements at one and six months.
Uncontrolled and resistant hypertension not only elevates risks of heart attack, stroke, and kidney disease but also adds to healthcare costs, hospitalisations, and productivity losses. Experts say that advanced therapies like RDN could help ease the long-term burden — enabling patients to rely on fewer medications, cut down hospital visits, and live healthier, more active lives.
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