title: Renal denervation for the treatment of hypertension: Making a new start, getting it right.
abstract: The renal nerves contribute to hypertension through effects in the kidney that enhance sodium retention and renin secretion, and by effects in the central nervous system that increase systemic sympathetic activity. Therefore, targeting the renal nerves provides a logical basis for treating hypertension. Several trials of renal denervation--achieved by applying radiofrequency energy through catheters placed in the renal arteries--have been completed. Clinical results have been inconsistent, however, partly because of factors related to the ablation technique and partly because these studies have been performed in patients with the inadequately defined clinical condition of "treatment-resistant hypertension." This statement now explains our conclusion that future studies of renal denervation should be guided by the established randomized, controlled clinical trial designs used for studying antihypertensive drugs and other treatments for hypertension.
authors.affiliation: Cardiovascular Division, Downstate Medical Center, State University of New York, Brooklyn, NY.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Weber
authors.affiliation: Center for Interventional Vascular Therapy, Columbia University Medical Center, New York, NY.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kirtane
authors.affiliation: Brigham and Women's Hospital, Harvard Clinical Research Institute and Harvard Medical School, Boston, MA.
authors.forename: Laura
authors.initials: L
authors.lastname: Mauri
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Townsend
authors.affiliation: Piedmont Heart Institute, Atlanta, GA.
authors.forename: David E
authors.initials: DE
authors.lastname: Kandzari
authors.affiliation: Center for Interventional Vascular Therapy, Columbia University Medical Center, New York, NY.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
mesh_terms: D017763:Autonomic Denervation / Q000009:adverse effects / Q000379:methods*; D001794:Blood Pressure; D017115:Catheter Ablation / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D012107:Research Design; D012307:Risk Factors; D016896:Treatment Outcome