Current Status of Renal Denervation in Hypertension.
Over the past 7 years, prospective cohorts and small randomized controlled studies showed that renal denervation therapy (RDN) in patients with resistant hypertension is safe but associated with variable effects on BP which are not substantially better than medical therapy alone. The failure of the most rigorously designed randomized sham-control study, SYMPLICITY HTN-3, to meet the efficacy endpoints has raised several methodological concerns. However, recently reported studies and ongoing trials with improved procedural characteristics, identification of patients with true treatment-resistant hypertension on appropriate antihypertensive regimens further explore potential benefits of RDN. The scope of this review is to summarize evidence from currently completed studies on RDN and discuss future perspectives of RDN therapy in patients with resistant hypertension.
From the Division of Cardiology, Wayne State University, Detroit, MI, USA.
Alexander
A
Briasoulis
The ASH Comprehensive Hypertension Center, Department of Medicine, The University of Chicago Medicine, 5841 S. Maryland Ave MC 1027, Chicago, IL, 60637, USA. gbakris@gmail.com.
George L
GL
Bakris
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000379:methods*; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013562:Sympathectomy / Q000379:methods; D016896:Treatment Outcome
D000959:Antihypertensive Agents
Denervation; Kidney; Renal; Resistant hypertension; Sympathetic