title: Resistant Hypertension and Renal Nerve Denervation.
abstract: Patients with resistant hypertension are a subgroup of the hypertensive population that are at even greater risk of cardiovascular outcomes. Therapeutic options for these patients are limited to antihypertensive medications. However, renal denervation (RDN) is a novel nonpharmacologic intervention that involves a catheter-based ablation of the sympathetic nerves within the renal artery wall. The procedure initially showed promise with remarkable blood pressure reductions until the pivotal SYMPLICITY HTN-3 trial failed to demonstrate superiority of RDN over control. This trial was notable for a substantial placebo effect and an attenuated response to RDN. These findings, which contradicted those of prior studies, have raised numerous questions, including whether adequate RDN occurred in those patients. Further research is planned to resolve some of these questions and to clarify the role of RDN in treating patients with resistant hypertension.
authors.affiliation: University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Denker
authors.affiliation: University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
authors.forename: Debbie L
authors.initials: DL
authors.lastname: Cohen
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 / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000098:blood supply*; D016032:Randomized Controlled Trials as Topic; D012077:Renal Artery / Q000294:innervation*; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; renal denervation; resistant hypertension; sympathetic nervous system