[Percutaneous renal denervation in patients with resistant hypertension--first experiences in Austria]

Hypertension is a major public health issue. Many patients do not reach the target blood pressure despite antihypertensive combination therapy. Renal ablation is a new therapeutic approach for patients who are refractory. Using a percutaneous catheter-based approach the sympathetic nervous system is interrupted by radiofrequency ablation via both renal arteries.

We describe the first renal denervation in Austria in a patient included in the "SIMPLICITY HTN-2" trial with resistant hypertension. We report of a 59-year-old patient in whom adequate blood-pressure control could not be achieved despite antihypertensive combination therapy with 6 different drugs. The averaged baseline blood-pressure was 238/132. Three months after renal denervation blood pressure dropped to 154/87 and medication was reduced on patient's request to 4 drugs. At 6-month follow-up 24h ambulatory blood-pressure monitoring was performed with an average value of 132/81. No adverse alterations of renal function could be detected.

This case report is in line with studies, which show that renal denervation of the sympathetic nervous system is a promising and safe therapeutic option in patients with resistant hypertension. Nevertheless prospective randomized controlled trials will have to confirm the therapeutic effects and further implications of this new therapeutic modality.