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How Does Renal Denervation Lower Blood Pressure and When Should This Technique Be Considered for the Treatment of Hypertension?

  • Hypertension (M Sorrentino, Section Editor)
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Abstract

Resistant hypertension poses significant health concerns. There are strong demands for new safe therapeutics to control resistant hypertension, while addressing its common causes, specifically poor compliance to lifelong polypharmacy, lifestyle modification and physician inertia. The sympathetic nervous system plays a significant pathophysiological role in hypertension. Surgical sympathectomy for blood pressure reduction is an old but extremely efficacious therapeutic concept, since abandoned, with the dawn of safer contemporary pharmacology era. Recently, clinical studies have revealed promising results for safe and sustained blood pressure reduction with percutaneous renal sympathetic denervation. This is a novel, minimally-invasive, device-based therapy, specifically targeting and ablating the renal artery nerves with radiofrequency waves, without permanent implantation. There are also reported additional benefits in related comorbidities, such as impaired glucose metabolism, renal impairment, left ventricular hypertrophy, heart failure, and others. This is review will focus on how selective renal sympathetic denervation works, as well as its present and potential therapeutic indications.

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Conflict of Interest

Kui Toh Gerard Leong is the Site PI (Changi General Hospital, Singapore) for the Global Symplicity Registry. Henry Krum has received a research grant to perform the Symplicity studies from Medtronic; has served on the local Advisory Board for Medtronic; and has received payment for lectures from Medtronic.

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  1. Department of Cardiology, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore

    Kui Toh Gerard Leong

  2. Center of Cardiovascular Research and Education in Therapeutics, Monash University, 99 Commercial Road, Melbourne, VIC, 3004, Australia

    Henry Krum

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Leong, K.T.G., Krum, H. How Does Renal Denervation Lower Blood Pressure and When Should This Technique Be Considered for the Treatment of Hypertension?. Curr Cardiol Rep 15, 414 (2013). https://doi.org/10.1007/s11886-013-0414-y

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