title: [Heart and kidneys. Renal denervation as therapy for hypertension].
abstract: Arterial hypertension is a major cardiovascular risk factor with a high prevalence in western industrial countries and the proportion of patients with blood pressure at target values remains low. Patients with therapy-resistant hypertension, defined as failure to achieve target blood pressure despite a triple antihypertensive drug regimen including a diuretic, are at very high risk which supports the need for greater efforts towards improving hypertension outcomes in this population. Secondary causes of hypertension are often found in patients with resistant hypertension. Activation of the sympathetic nervous system has been identified as a main contributor to the development and progression of high blood pressure. Catheter-based renal denervation offers a new interventional treatment option resulting in a significant long-term reduction in blood pressure (> 36 months) and increased blood pressure control (up to 40% of the treated population). The basis for successful treatment is an appropriate patient selection, including life-style modification, exclusion of pseudoresistance, termination of substances increasing blood pressure and an optimized drug treatment. Further clinical studies are warranted and ongoing to determine the role of renal denervation in antihypertensive treatment.
authors: Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Kirrberger Strasse Geb. 40, Homburg/Saar, Germany. Felix.Mahfoud@uks.eu
authors: F
authors: F
authors: Mahfoud
authors: D
authors: D
authors: Linz
authors: M
authors: M
authors: Böhm
mesh_terms: D017763:Autonomic Denervation / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000601:surgery*; D007668:Kidney / Q000294:innervation* / Q000601:surgery*
references: Dtsch Med Wochenschr. 2010 Dec;135(48):2422-5
references: 21108158
references: Lancet. 2012 Aug 25;380(9843):778
references: 22920752
references: J Hypertens. 2012 Nov;30(11):2230-9
references: 22914572
references: Circulation. 2012 Apr 3;125(13):1635-42
references: 22379110
references: J Hypertens. 2007 Jun;25(6):1105-87
references: 17563527
references: J Am Coll Cardiol. 2011 Sep 6;58(11):1176-82
references: 21884958
references: Lancet. 2010 Dec 4;376(9756):1903-9
references: 21093036
references: Hypertension. 2011 May;57(5):898-902
references: 21444835
references: Dtsch Med Wochenschr. 2011 Nov;136(47):2418
references: 22048949
references: Dtsch Med Wochenschr. 2012 Nov;137(48):2505-10
references: 23168986
references: Dtsch Med Wochenschr. 2012 Nov;137(48):2480-4
references: 23168980
references: Circulation. 2008 Jun 24;117(25):e510-26
references: 18574054
references: Dtsch Arztebl Int. 2011 Oct;108(43):725-31
references: 22114648
references: Lancet. 2009 Apr 11;373(9671):1275-81
references: 19332353
references: Clin Res Cardiol. 2011 Dec;100(12):1049-57
references: 21688196
references: J Hypertens. 2012 May;30(5):837-41
references: 22469838
references: Am J Physiol Regul Integr Comp Physiol. 2005 Sep;289(3):R633-41
references: 16105818
references: J Am Coll Cardiol. 2012 Dec 25;60(25):2694-5
references: 23141482