Renal sympathetic denervation for the treatment of systemic hypertension.
Systemic hypertension is a common cardiovascular problem that often cannot be fully treated with existing nonpharmacologic and pharmacologic measures. A catheter-based strategy which denervates the renal afferent and efferent autonomic nervous system has been developed for the treatment of drug-resistant hypertension. In early clinical trials, this procedure was shown to be both feasible and safe in reducing blood pressure in patients with uncontrolled hypertension receiving treatment with a minimum of 3 antihypertensive drugs. In addition, this procedure has been associated with decreased renin secretion, preservation of renal function, improved glucose tolerance, and a reduction in left ventricular hypertrophy. The long-term effects of this procedure (beyond 3 years) still need to be determined. A large 530-patient sham-controlled trial is now in progress.
Department of Internal Medicine, Boston University Medical Center, Boston, MA, USA.
Gordon M
GM
Burke
Domenic A
DA
Sica
William H
WH
Frishman
D001794:Blood Pressure; D017115:Catheter Ablation; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D013562:Sympathectomy; D013564:Sympathetic Nervous System / Q000601:surgery*; D017211:Treatment Failure