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Renal Sympathetic Nerve Ablation: The New Frontier in the Treatment of Hypertension

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Abstract

The sympathetic nervous system plays an important role in circulatory and metabolic control and has clearly been established as a major contributor to the development of hypertension, as elevated sympathetic nerve activity initiates and sustains the elevation of blood pressure. Increased sympathetic outflow to the heart, resulting in increased cardiac output and neurally mediated vasoconstriction of peripheral blood vessels, is an obvious example of a neural pathophysiologic pathway leading to elevated blood pressure. The consequences of increased sympathetic outflow to the kidneys, perhaps most important in this context, are sodium and water retention, increased renin release, and alterations of renal blood flow—effects that contribute substantially to both acute and long-term blood pressure elevations. Accordingly, renal sympathetic nerve ablation appears to be a logical therapeutic approach for the treatment of hypertension. Recent reports on a novel catheter-based renal nerve ablation procedure reviewed in this article are promising.

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Disclosure

Dr. Sobotka is an employee of Ardian, Inc.; Dr. Schlaich and Dr. Krum are principal investigators in clinical trials sponsored by Ardian, Inc. (NCT00483808 and NCT00551304 at http://ClinicalTrials.gov). Dr. Schlaich is supported by a Senior Research Fellowship from the National Health and Medical Research Council (NHMRC) of Australia.

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Authors and Affiliations

  1. Neurovascular Hypertension & Kidney Disease Laboratory, Baker IDI Heart & Diabetes Institute, PO Box 6492, St. Kilda Road Central, Melbourne, Victoria, 8008, Australia

    Markus P. Schlaich

  2. Monash Centre of Cardiovascular Research & Education in Therapuetics, Dept. of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia

    Henry Krum

  3. Dept. of Cadiology, Hennepin County Medical Center, Minneapolis, MN, USA

    Paul A. Sobotka

  4. ARDIAN Inc., Palo Alto, CA, USA

    Paul A. Sobotka

Authors
  1. Markus P. Schlaich
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  2. Henry Krum
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  3. Paul A. Sobotka
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Correspondence to Markus P. Schlaich.

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Schlaich, M.P., Krum, H. & Sobotka, P.A. Renal Sympathetic Nerve Ablation: The New Frontier in the Treatment of Hypertension. Current Science Inc 12, 39–46 (2010). https://doi.org/10.1007/s11906-009-0078-6

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