Renal denervation and treatment of hypertension.
Cardiovascular diseases kill more people each year than any other diseases. In 2008, 7.3 million people died of ischaemic heart disease, 6.2 million from stroke or another form of cerebrovascular disease. Hypertension affects about 1 billion people worldwide and is a major risk factor for many cardiovascular diseases, including coronary heart disease and stroke. In contrast, our knowledge in regard to the underlying molecular mechanisms remains incomplete and, as a consequence, it is difficult if not impossible to efficiently treat the most affected patients. While the development and application of novel pharmacological agents in combination with lifestyle changes have been applied in Western developed countries to a large number of patients, a significant number of individuals fail to respond. Recently, several novel approaches have been developed including a minimally invasive catheter-based renal nerve ablation technique and some of the consequences will be highlighted in this brief review article. This will include the discussion of previous attempts to denervate the renal arteries as well as the significant improvements achieved when catheter-based interventions are applied.
Imperial College, National Heart & Lung Institute, British Heart Foundation - Centre of Research Excellence, Imperial Centre for Translational and Experimental Medicine, London, UK. r.knoell@imperial.ac.uk
Ralph
R
Knöll
D000818:Animals; D001794:Blood Pressure; D017115:Catheter Ablation; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000098:blood supply* / Q000294:innervation*; D012077:Renal Artery / Q000294:innervation*; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome