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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
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Catheter-based renal artery denervation: facts and expectations
Paolo Verdecchia1, Claudio Cavallini1, Rocco Sclafani1
1Division of Cardiology, Hospital S. Maria della Misericordia, Perugia, Italy.
European Journal of Internal Medicine
|August 6, 2023
Summary
Catheter-based renal artery denervation (RAD) is now recommended by ESH guidelines. Recent trials show RAD effectively lowers blood pressure in both untreated and resistant hypertension patients, with no significant safety concerns.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Hypertension Management
Background:
- Catheter-based renal artery denervation (RAD) has evolved significantly since the SYMPLICITY-HTN 3 trial.
- Recent advancements have led to promising results in SHAM-controlled randomized trials.
- The 2023 European Society of Hypertension (ESH) Guidelines now recommend RAD (Class II, Level of Evidence B).
Approach:
- This review synthesizes current data on catheter-based RAD.
- An updated meta-analysis of SHAM-controlled trials is included.
- The analysis examines RAD's efficacy in both untreated and treated hypertensive patients.
Key Points:
- RAD demonstrated a significant reduction in 24-hour systolic blood pressure compared to SHAM procedures.
- Reductions were observed in both untreated (4.58 mmHg) and treated (3.82 mmHg) hypertensive patients.
- No significant heterogeneity was found across patient phenotypes or techniques (radiofrequency vs. ultrasound).
Conclusions:
- Catheter-based RAD is effective as a first-line treatment for untreated hypertension and for difficult-to-control resistant hypertension.
- The procedure shows a favorable safety profile.
- RAD may be beneficial in conditions with sympathetic nervous system overactivity, such as atrial fibrillation.
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