[Renal artery denervation for treating refractory hypertension]

Area of Science:

• Cardiology
• Nephrology
• Interventional Radiology

Background:

• Arterial hypertension affects 30-40% of adults in industrialized nations, often remaining uncontrolled despite multiple medications.
• Resistant hypertension poses a significant risk for cardiovascular events, necessitating alternative therapeutic strategies.

Observation:

• Percutaneous renal denervation uses radiofrequency energy via a catheter to reduce renal afferent nerve activity.
• Eligibility criteria include uncontrolled essential hypertension on three drugs (including a diuretic) and a glomerular filtration rate ≥ 45mL/min.

Findings:

• The Symplicity HTN-2 trial demonstrated a significant mean blood pressure reduction of 32/12 mmHg post-renal denervation.
• This blood pressure decrease was sustained at 24-month follow-up with no reported complications or renal function impairment.

Implications:

• Renal denervation is a promising, safe, and effective strategy for managing treatment-resistant hypertension.
• This minimally invasive approach offers a durable solution, potentially reducing cardiovascular event risk in a challenging patient population.