title: Response and non-response to renal denervation: who is the ideal candidate?
abstract: Catheter-based renal denervation (RDN) leads to a considerable decrease of blood pressure in the vast majority of patients with resistant hypertension. However, only minor or no blood pressure change is achieved in some patients. This non-reponse is defined as a reduction of office systolic blood pressure of less than 10 mmHg following RDN. The rates of non-response vary between 8-37%. Here several causes are discussed such as inappropriate patient selection, an ineffective procedure, the subordinate contribution of sympathetic activation for the maintenance of hypertension, and patient conditions such as non-adherence to drug therapy. Based on current evidence, an ideal candidate for RDN has high baseline blood pressure, which is known to be the best predictor for blood pressure reduction after RDN. In order to ensure treatment success further criteria have to be fulfilled, such as exclusion of secondary hypertension and optimised medical therapy.
authors.affiliation: Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. Christian.Ukena@uks.eu
authors.forename: Christian
authors.initials: C
authors.lastname: Ukena
authors.forename: Bodo
authors.initials: B
authors.lastname: Cremers
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ewen
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.forename: Felix
authors.initials: F
authors.lastname: Mahfoud
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D017115:Catheter Ablation / Q000009:adverse effects; D004351:Drug Resistance; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D055118:Medication Adherence; D018579:Patient Selection; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013564:Sympathetic Nervous System / Q000503:physiopathology / Q000601:surgery*; D017211:Treatment Failure
chemical_list: D000959:Antihypertensive Agents