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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
Renal sympathetic denervation for resistant hypertension
Michael Froeschl1, Adnan Hadziomerovic, Marcel Ruzicka
1Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, University of Ottawa, Ottawa, Ontario, Canada. mfroeschl@ottawaheart.ca
The Canadian Journal of Cardiology
|April 2, 2013
Summary
Percutaneous renal sympathetic denervation (RSD) shows promise for treating resistant hypertension by reducing blood pressure. However, more robust evidence is needed to confirm its long-term efficacy and safety.
Area of Science:
- Cardiology
- Nephrology
- Medical Devices
Background:
- Resistant hypertension is a growing concern linked to cardiovascular issues.
- Sympathetic nervous system and renin-angiotensin-aldosterone system overactivity play key roles.
- Renal sympathetic nerves in renal arteries are a potential therapeutic target.
Purpose of the Study:
- To critically review the evidence supporting percutaneous renal sympathetic denervation (RSD) for resistant hypertension.
- To evaluate the efficacy and safety of RSD based on existing studies.
Main Methods:
- Review of existing studies on percutaneous renal sympathetic denervation (RSD).
- Analysis of data from trials like the Symplicity HTN-2, focusing on blood pressure reduction.
- Identification of limitations in current evidence, including study size and methodology.
Main Results:
- Small studies suggest RSD can significantly lower blood pressure, with one trial showing a mean reduction of 32/12 mm Hg.
- Limitations include small patient numbers, lack of placebo control, office-based BP assessments, and limited long-term data.
- Ongoing trials like Symplicity HTN-3 aim to address these evidence gaps.
Conclusions:
- Percutaneous renal sympathetic denervation (RSD) demonstrates potential for treating resistant hypertension.
- Further high-quality, long-term data on efficacy and safety are essential.
- RSD should be reserved for patients with uncontrolled resistant hypertension until more evidence is available.
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