Offer

In the hypertension consultation, we clarify the presence of high blood pressure, triggering factors, accompanying risk factors and concomitant illnesses or organ damage in a holistic manner. We then discuss all clarifications, results and treatment options with you at your leisure. During the treatment, you will be accompanied by your contact person.

As this is a chronic illness, we will arrange regular check-ups and follow-up care with you as part of a structured cardiovascular prevention concept. This is done in cooperation with your family doctors.

The presence of high blood pressure before or during pregnancy, as well as after birth and during breastfeeding, requires a special choice of medication and close monitoring and adjustment. If you wish, we can also provide you with telemedical support.

The presence of blood pressure disorders during or immediately after pregnancy increases the risk of developing cardiovascular disease later on. We will advise you on preventive measures, carry them out and support you in the process.

At the University Center for Hypertension, we have the full range of options for diagnosing and clarifying high blood pressure, any triggers and concomitant diseases. Before every consultation, we carry out standardized automated blood pressure measurements, as well as blood and urine tests to identify or monitor other risk factors and concomitant diseases or hormonal disorders. Depending on the situation, we also carry out various technical examinations such as electrocardiograms, 24-hour blood pressure measurements, ECGs, special blood pressure measurements, oxygen saturation measurements, imaging examinations of the heart, kidneys or blood vessels or eye examinations.

We are one of the few centers in Switzerland to offer a highly specialized examination in which we take targeted blood samples directly from the adrenal veins using a catheter. This adrenal vein catheterization is used to diagnose hormonal disorders, particularly in the aldosterone metabolism (which affects the kidneys and the water balance). This involves diseases such as hyperaldosteronism or Conn's disease, in which the adrenal glands produce too much aldosterone. This overproduction can be the cause of high blood pressure. The examination allows us to determine exactly whether only one or both adrenal glands are affected, which is important for further treatment.

We offer you an individually tailored therapy, taking into account all cardiovascular risk factors and concomitant illnesses. Depending on the situation, this includes advice on promoting a healthy lifestyle and various medications, which are usually used in combination. In special cases, however, interventional procedures such as catheter-assisted renal denervation, treatment of constrictions (stenoses) of the renal arteries with stents or surgical therapies, e.g. for hormonal disorders, can also be used.

The terms difficult-to-control, therapy-resistant and therapy-refractory hypertension are often used interchangeably.

European hypertension guidelines use the term resistant (or therapy-resistant) hypertension. This is defined as inadequate blood pressure control (usually >140/90 mmHg) despite appropriate lifestyle changes and drug therapy with at least three suitable active substances in optimal or maximum tolerated doses. Resistant hypertension is not an independent disease compared to arterial hypertension, but is an indicator of an increased risk of hypertension-associated end organ damage, for example to the heart or kidneys, and of the presence of secondary hypertension.Secondary hypertension is by definition based on an identifiable and potentially treatable cause (e.g. renal artery stenosis or hormonal disease). It is therefore recommended that patients with resistant hypertension are referred to specialized centers for further treatment and clarification.

The terms difficult-to-control and therapy-refractory hypertension are not uniformly defined. Whereas difficult-to-control hypertension can also include situations in which blood pressure control is difficult not only because blood pressures are too high but also too low at times, refractory hypertension often refers to even more severe forms of the disease than resistant hypertension.

Secondary forms of hypertension are defined as high blood pressure that is triggered by specific diseases. These include, for example, hormonal diseases (e.g. primary hyperaldosteronism/M. Conn, pheochromocytoma, hypercortisolism/M. Cushing), kidney diseases (renal insufficiency for various reasons), vascular diseases (e.g. renal artery stenosis, aortic coarctation).

Many of these diseases can be treated in a targeted manner, be it with specific medication, surgery or certain aids. For this reason, if there are indications of possible secondary forms of hypertension, we look specifically for these diseases, e.g. by means of blood tests, special ultrasound or other radiological examinations or using special equipment.

We work closely with the relevant specialists both in the diagnosis and treatment of secondary forms of hypertension and accompany you on this path.

High blood pressure can lead to damage to various organs. A distinction is made between "clinical" and "subclinical" damage. "Subclinical" damage means that damage already exists but does not yet lead to symptoms.

The organs affected are in particular the heart, blood vessels, kidneys, brain and eyes. Depending on the clinical situation, we look for thickening of the heart muscle and changes in the heart chambers, cardiac arrhythmia, calcifications in the blood vessels, traces of protein in the urine, changes in the size of the kidneys, deposits in the brain or changes in the blood vessels in the eye.

Subclinical damage is regarded as a warning signal before clinical damage such as a heart attack or stroke. They help us to provide you with the right therapy to prevent clinical damage.

As adequate blood pressure control cannot always be achieved despite the fact that antihypertensive medication is usually well tolerated and effective, several interventional, i.e. minimally invasive catheter-based therapy methods have been developed for the treatment of hypertension.Renal denervation is the best-studied interventional hypertension therapy and is now also recommended as a treatment option by the European hypertension guidelines.

The aim of renal denervation is to reduce the activity of the sympathetic nervous system ("stress nervous system"). Overactivity of the sympathetic nervous system contributes to the development and progression of various cardiovascular diseases, including high blood pressure, heart failure, cardiac arrhythmia, kidney disease and diabetes. Renal denervation ablates ("obliterates") some of the sympathetic nerve fibers that run in a network along the renal artery.

The procedure is performed in a similar way to a cardiac catheterization. The femoral artery, which is punctured immediately below the inguinal ligament, is used as the main vascular access point. Special catheters are inserted into the renal artery under fluoroscopic guidance.Various catheter systems are available for renal denervation, most of which are based on radiofrequency or ultrasound energy. As a rule, the arteries of the left and right kidneys are treated. The denervation catheter is removed after the treatment so that no implants remain in the body.

The femoral artery is punctured under local anesthesia. Pain medication is administered during the procedure. General anesthesia is not required.