, Volume 13, Issue 6, pp 478-480
Date: 16 Aug 2011

Can Catheter-Based Renal Denervation Be Used Safely and Effectively to Substantially Reduce Blood Pressure in Treatment-Resistant Hypertensive Patients?

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Trial: Esler MD, Krum H, Sobotka PA, et al.: Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 2010, 376:1903–1909.

Rating: Of significant importance.

Introduction: Successful treatment of elevated blood pressure (BP) has proven elusive despite availability of various drugs, combination pharmaceutical products, and resources to assist patients’ adherence and lifestyle changes. The failure of present strategies suggests underlying pathophysiology that is refractory to available interventions. Renal sympathetic nerves contribute to development and perpetuation of hypertension, and sympathetic outflow to the kidneys is activated in patients with essential hypertension. Efferent sympathetic outflow stimulates renin release, increases tubular sodium reabsorption, and reduces renal blood flow. Afferent signals from the kidney modulate central sympathetic outflow and thereby directly contribute to