"Maxed out on the medications is how Bill Ezzell describes his struggle with blood pressure. Its dangerously high even though the North Carolina man swallows six different drugs a day. Hypertension may be the nations sneakiest epidemic a time bomb thats a leading cause of heart attacks strokes and kidney failure and one thats growing worse as the population rapidly grows older.  Despite an arsenal of drugs millions of people in the United States cant get their blood pressure down to safe levels. Now in a highstakes experiment at dozens of hospitals scientists are testing a dramatically different approach for the toughest to treat patients by burning away some overactive nerves deep in the body that can fuel rising blood pressure.  To attempt an invasive treatment  a catheter is threaded through blood vessels in the groin up to the kidneys  reflects doctors frustration with a disease that too often is underrated because people with it dont look or feel sick until a lot of damage has been done.  Pharmaceutical therapies have been the cornerstone of medicine for nearly a century offering convenient noninvasive treatment for countless diseases. But when it comes to some of the most stubborn chronic conditions including diabetes obesity and hypertension medications too often arent enough.  Researchers increasingly are trying medical devices and minimally invasive surgeries to help such as stomachshrinking techniques that improve obesitycaused diabetes and the new hypertension experiment.  I think we have to hit on all cylinders if were going to take on these very important diseases said Dr. Steven Nissen chair of the Cleveland Clinics department of cardiology. There are many examples where this convergence is taking place where you push the drugs as far as you can but when they cant go any further you step in with more invasive approaches. Cardiologists interest in the nervezapping procedure also reflects how severe the burden of hypertension is poised to become with many middleaged boomers already affected.  People are living longer with hypertension and the disease tends to get worse as you get older said Dr. Suzanne Oparil a hypertension specialist at the University of Alabama Birmingham. The complications pile on later.  Deaden the nerves relax the arteries If deadening kidney nerves sounds like a strange way to attack hypertension consider that nerves in the bodys fight or flight system play a role in signaling kidney functions which in turn help regulate blood pressure such as by relaxing or tightening key arteries.  If there was a snake in the room all of our blood pressures would go up appropriately so explained interventional cardiologist Dr. Manesh Patel of Duke University one of more than  medical centers around the country studying Medtronic Inc.s nervezapping procedure.  But sometimes those nerves stay switched on when they shouldnt be something todays medications cant address. The hope is that destroying a small number of the nerves could calm an overactive system relaxing arteries and lowering blood pressure.  Interrupting that signal makes physiologic sense Patel said adding that some patients have driven hundreds of miles to see if theyre candidates. Theres a large unmet need.  Some  million people in the country about  in  adults have high blood pressure meaning readings of  over  or higher. An additional  million people will have it by  says a grim forecast from the American Heart Association. Thats because the population is getting fatter and older. In fact about half of people in their s have high blood pressure but by age  threefourths do.  If people live long enough the vast majority are going to have hypertension says Dr. Michael Mussolino of the National Institutes of Healths cardiovascular division.  Only about half of patients have their hypertension under control. Most need multiple drugs to treat it. Some  percent more than  million people like Ezzell have the resistant hypertension that is the initial target of the nervezapping procedure  people with high blood pressure despite three or more different kinds of medications.  Renal denervation the procedure being promoted by Minneapolisbased Medtronic and other companies has its roots in primitive nervesevering operations performed in the s which often lowered blood pressure but at the expense of permanently injuring patients. Only in recent years have researchers revisited the technique after companies developed easytouse catheters that can beam radiofrequency waves to burn away specific nerves without damaging the surrounding blood vessel.  Hardesttotreat patients only Its aimed at only the hardesttotreat patients. In small Medtronic studies those treated saw the key top number of a blood pressure reading drop an average of  points although they still needed their medications. Medtronic reported in March that the improvements were lasting up to three years. The companys Symplicity catheter is approved to treat hypertension in Europe and Australia as are some competitors versions.  The U.S. Food and Drug Administration required a more rigorous study now enrolling more than  people that includes an unusual step to prove if it really works. Some patients receive the real procedure and some get a fake  just the catheter no zapping. Patel describes patients wearing a blindfold and earphones while lying sedated on the treatment table to ensure they dont know which theyre getting.  Although pilot studies show few side effects potential risks include bleeding an injured blood vessel immediate blood pressure or heartbeat problems or complications from medications used in the procedure.  Ezzells systolic pressure that top number hovers around  and sometimes jumps to a superdangerous  despite his six daily drugs.  The doctors seemed at wits end as to what to do about it says Ezzell  of Jacksonville N.C. So he got on the Internet tracking down the Medtronic study at Duke about two hours away.  Ezzell was treated this month and is waiting to see if his blood pressure drops which earlier research shows happens gradually over six months.  Cardiologists are excited by the early findings said Dr. Gordon Tomaselli the heart associations president.  But what we dont know is the longterm effect of nerve zapping Tomaselli cautioned. Its going to take a little bit of time to make sure there are not adverse effects two years three years  years down the line.  In the last three years the FDA has approved similar catheters that beam radio waves to treat asthma and a type of irregular heartbeat conditions traditionally treated with medications.  Companies scramble to compete More than five dozen companies are pursuing devices for hypertension from catheters similar to Medtronics to permanent implants left in arteries to regulate blood pressure.  In Europe Medtronics hypertension procedure costs about  sticker shock compared with the generic prices of standard hypertension medications and another reason for careful study to prove its effects.  Gwen Dirks  of Virginia Ill. was grateful to get the procedure in an early study. Her blood pressure was  over  despite two drugs.  Ive been on medications since I was  Dirks said. Over the years I have tried many different things and got to the point where they no longer worked.  Two years after her experimental treatment Dirks says her blood pressure is stable at about  over  although she continues to take her medications."