Catheter-based Renal Artery Denervation for Resistant Hypertension: Promise Unfulfilled or Unsettled?
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Resistant hypertension affects approximately 10–15 % of the hypertensive population and is associated with an increased occurrence of adverse cardiovascular outcomes. Recently, renal denervation (RDN) has emerged as a novel, non-pharmacologic therapy for resistant hypertension that is designed to ablate the sympathetic nerves distributed around the renal arteries, thus diminishing sympathetic nervous system activity and its influence on hypertension. RDN appeared to have a powerful BP-lowering effect in early clinical trials. However, a pivotal follow-up trial, SYMPLICITY HTN-3, showed no additional benefit of the therapy when compared with a sham procedure. Various aspects of the trial have been examined to explain this inconsistency, including a potent placebo effect and uncertainty about whether RDN actually occurred. Further research is needed to clarify the role of RDN in the management of resistant hypertension.
KeywordsRenal denervation Sympathetic nervous system Resistant hypertension Blood pressure
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Conflict of Interest
Matthew G. Denker declares that he has no conflict of interest.
Debbie L. Cohen has received a grant and travel support from Medtronic.
Raymond R. Townsend has received consulting fees/honorarium from Medtronic and funding from the NIH.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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