title: Updated ESH position paper on interventional therapy of resistant hypertension.
abstract: Out of the overall hypertensive population it is estimated that approximately 10% have treatment resistant hypertension (TRH). Percutaneous catheter-based transluminal renal ablation (renal denervation [RDN] by delivery of radiofrequency energy) has emerged as a new approach to achieve sustained blood pressure reduction in patients with TRH. This innovative interventional technique is now available across Europe for severe TRH for those patients in whom pharmacologic strategies and lifestyle changes have failed to control blood pressure below target (usually <140/90 mmHg). In 2012, the "ESH position paper: renal denervation - an interventional therapy of resistant hypertension" was published to facilitate a better understanding of the effectiveness, safety, limitation and unresolved issues. We have now updated this position paper since numerous studies have been published over the last year providing more data about the rationale, therapeutic efficacy and safety of RDN. In the upcoming ESH/ESC guidelines for the management of arterial hypertension, therapeutic options of treatment resistant hypertension will be addressed, but only briefly, and thus it is the focus of this paper to provide detailed and updated information on this innovative interventional technique.
authors.affiliation: University Hospital Erlangen, Nephrology and Hypertension, Erlangen, Germany. roland.schmieder@uk-erlangen.de
authors.forename: Roland E
authors.initials: RE
authors.lastname: Schmieder
authors.forename: Josep
authors.initials: J
authors.lastname: Redon
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.forename: Luis
authors.initials: L
authors.lastname: Ruilope
authors.forename: Philippe
authors.initials: P
authors.lastname: van de Borne
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D017115:Catheter Ablation / Q000009:adverse effects / Q000592:standards*; D004351:Drug Resistance; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D011237:Predictive Value of Tests; D013562:Sympathectomy / Q000009:adverse effects / Q000592:standards*; D013564:Sympathetic Nervous System / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents