[Percutaneous renal denervation in patients with resistant hypertension--first experiences in Austria].
BACKGROUND
Hypertension is a major public health issue. Many patients do not reach the target blood pressure despite antihypertensive combination therapy. Renal ablation is a new therapeutic approach for patients who are refractory. Using a percutaneous catheter-based approach the sympathetic nervous system is interrupted by radiofrequency ablation via both renal arteries.


RESULTS
We describe the first renal denervation in Austria in a patient included in the "SIMPLICITY HTN-2" trial with resistant hypertension. We report of a 59-year-old patient in whom adequate blood-pressure control could not be achieved despite antihypertensive combination therapy with 6 different drugs. The averaged baseline blood-pressure was 238/132. Three months after renal denervation blood pressure dropped to 154/87 and medication was reduced on patient's request to 4 drugs. At 6-month follow-up 24h ambulatory blood-pressure monitoring was performed with an average value of 132/81. No adverse alterations of renal function could be detected.


CONCLUSIONS
This case report is in line with studies, which show that renal denervation of the sympathetic nervous system is a promising and safe therapeutic option in patients with resistant hypertension. Nevertheless prospective randomized controlled trials will have to confirm the therapeutic effects and further implications of this new therapeutic modality.
Universitätklinik für Innere Medizin II, Medizinische Universität Wien, Wien, Austria. georg.goliasch@meduniwien.ac.at
Georg
G
Goliasch
Michael
M
Wolzt
Peter
P
Höfer
Georg
G
Delle-Karth
Gerhard
G
Kreiner
Thomas
T
Neunteufel
Gerald
G
Maurer
Thomas
T
Binder
D002908:Chronic Disease; D003714:Denervation / Q000379:methods*; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000601:surgery*; D007668:Kidney / Q000294:innervation* / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome