title: Renal sympathetic denervation in hypertension.
abstract: OBJECTIVE
  Despite the abundance of antihypertensive drugs, resistant hypertension remains a major clinical problem. Recent technological advances render interventional management of resistant hypertension one of the hottest topics in the hypertension field. The aim of this review is to present the pathophysiologic background and the mechanisms mediating blood pressure reduction after renal sympathetic denervation, to analyze recent findings with this fascinating approach and to critically suggest future research directions.
  
  
  RESULTS
  Catheter-based, ablation-induced renal sympathetic denervation was initially studied in 45 patients with resistant hypertension in a proof-of-concept study. Impressive blood pressure reductions of about 30/15  mmHg were achieved at 6 months, without serious complications. A second, controlled, randomized (but not blinded) study confirmed the results, verifying the efficacy and safety of the procedure. A recent report revealed the 2-year durability of blood pressure reduction.
  
  
  CONCLUSIONS
  Data published so far indicate that ablation-induced renal denervation is a feasible, effective, and well tolerated interventional approach for the management of resistant hypertension. The groundbreaking studies of renal denervation in drug-resistant hypertension pave the way for further research in other disease conditions in which sympathetic overactivity seems to play a critical role. This initial wave of enthusiasm needs to be followed by rigorous investigation, for the proper identification of the potential and the limitations, indications, and contraindications of this approach.
authors: Veterans Affairs Medical Center - George Washington University, Washington, DC 20422, USA. michalisdoumas@yahoo.co.uk
authors: Michael
authors: M
authors: Doumas
authors: Charles
authors: C
authors: Faselis
authors: Vasilios
authors: V
authors: Papademetriou
mesh_terms: D000959:Antihypertensive Agents / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D017115:Catheter Ablation / Q000009:adverse effects; D004351:Drug Resistance; D005947:Glucose / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D007333:Insulin Resistance; D007668:Kidney / Q000294:innervation* / Q000503:physiopathology / Q000601:surgery; D016032:Randomized Controlled Trials as Topic; D013562:Sympathectomy / Q000009:adverse effects
chemical_list: D000959:Antihypertensive Agents; D005947:Glucose