Focused Power Ultrasound Mediated Inferior Perirenal Adipose Tissue Modification Therapy for Essential Hypertension (PARADISE HTN-III)

Prior treatment

• Individuals taking other medications that may affect blood pressure (such as glucocorticoids);

Other illness

• Individual diagnosed as secondary hypertension (e.g. renal parenchymal hypertension, renal artery stenosis, primary aldosteronism, pheochromocytoma, Cushing's syndrome, aortic coarctation, obstructive sleep apnea hypopnea syndrome)；
• riser hypertension (defined as night blood pressure higher than daytime blood pressure by ABPM)
• Individual with history of kidney or kidney surrounding tissue surgery;
• Individual with myocardial infarction, unstable angina pectoris, cerebrovascular accident or transient ischemic attack within 6 months of enrollment;
• Individual with type 1 diabetes or uncontrolled type 2 diabetes；
• Individual with severe structural heart disease (e.g. valvular heart disease, cardiomyopathy, congenital heart disease);
• Individual with second degree and above atrioventricular block and/or sick sinus syndrome;
• Individual with infected waist skin;
• Individual with malignant tumor;
• History of allergy to amlodipine, olmesartan, and hydrochlorothiazide

Lab values

• Individuals with ≥ 3 cardiovascular risk factors (male\>55 years old, female\>65 years old; smoking or passive smoking; 2-hour postprandial blood glucose 7.8-11mmol/L and/or impaired fasting glucose (6.1-6.9mmol/L); LDL-C ≥ 3.4mmol/L (130mg/dl), HDL-C\<1.0mmol/L (40mg/dl) or TC ≥ 5.2mmol/L (200mg/dl); Family history of early onset of cardiovascular disease, age of onset of first degree relatives\<50 years old; Abdominal obesity, waist circumference: male\>90cm, female\>85cm or BMI\>28kg/m2) or hypertensive target organ damage;
• Individuals with impairment of liver or kidney function (ALT, AST or creatinine greater than 2 times of the upper limit of normal reference);

Other

• Regular night shift workers
• Individual with uncontrolled thyroid dysfunction;
• Individual with urinary calculi or hematuria；
• Individual with atrial fibrillation;
• Individual with abnormal coagulation function;
• Individual with claustrophobia；
• Individual is pregnant, nursing or planning to be pregnant;
• Individual is unwilling to sign informed consent;
• Individual fails to complete the screening period.

• Individual with office systolic blood pressure (SBP) ≥ 140 mmHg and \<160 mmHg, and office diastolic blood pressure (DBP)\<100mmHg after standardized antihypertensive drug treatment for 1 month;
• Individual with 24-hour Ambulatory Blood Pressure Monitoring (ABPM) average systolic blood pressure (ASBP) ≥130 mmHg；
• The anteroposterior, transverse and axial diameters of inferior perirenal fat pad measured by ultrasound should be at least 20mm；
• Individual is willing to sign the informed consent of the study.