In these cases, I treat hypertension with renal ablation

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Nephrology

Background:

• Systemic arterial hypertension is a major global health concern with many patients unresponsive to standard treatments.
• Renal denervation (RDN) targets the renal sympathetic nervous system, offering a novel therapeutic strategy.
• Variable results from clinical trials necessitate refined patient selection and understanding of RDN's role.

Purpose of the Study:

• To review the current evidence and guidelines for renal denervation in managing systemic arterial hypertension.
• To highlight RDN's potential as a breakthrough therapy for resistant hypertension.
• To emphasize the importance of patient selection and multi-disciplinary assessment for optimizing RDN outcomes.

Main Methods:

• Review of recent clinical trials (SYMPLICITY HTN-3, SPYRAL HTN-OFF MED, RADIANCE-HTN SOLO).
• Analysis of the 2024 European Society of Cardiology (ESC) guidelines regarding RDN.
• Discussion of RDN technologies (ultrasound, radiofrequency) and their application.

Main Results:

• Clinical trial results for RDN have been variable, influenced by patient selection and study design.
• The 2024 ESC guidelines endorse RDN for selected cases of resistant hypertension.
• Individual patient pathophysiology and sympathetic activation levels impact RDN response.

Conclusions:

• Renal denervation represents a promising therapeutic option for patients with resistant hypertension inadequately controlled by medication.
• Ultrasound and radiofrequency RDN technologies may bridge therapeutic gaps and reduce long-term cardiovascular risk.
• A multi-disciplinary approach is crucial for maximizing the benefits of renal denervation.