[Interventional renal sympathetic denervation - a new approach for patients with resistant hypertension].
The pathophysiology of resistant hypertension is complex. Activation of the sympathetic nervous system has been suggested to be one of the main contributors for maintenance of blood pressure elevation and the development of comorbidities. Catheter-based renal denervation - by ablation of the efferent and afferent renal sympathetic nerves - is a new approach to selectively denervate the kidneys from their sympathetic control. Renal denervation is associated with substantial and sustained blood pressure reduction (24 months), lowers central sympathetic outflow, and reduces whole-body norepinephrine spillover. The procedure is feasible and safe. The randomised controlled Symplicity-HTN-2 trial (results reported at AHA 2010, Nov 13-17) provides important information to determine the role of this new method for the treatment of drug resistant hypertension.
Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar. felix.mahfoud@uks.eu
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Böhm
D000344:Afferent Pathways / Q000502:physiology / Q000503:physiopathology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001012:Aorta, Abdominal / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004525:Efferent Pathways / Q000502:physiology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012077:Renal Artery / Q000503:physiopathology; D013562:Sympathectomy / Q000379:methods*
D000959:Antihypertensive Agents