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Renal Denervation for Uncontrolled Hypertension: A Health Technology Assessment.
Ontario Health Technology Assessment Series
|February 26, 2026
Summary
Renal denervation effectively lowers blood pressure in uncontrolled hypertension patients. While more costly than standard care, it offers a favorable option, especially when other treatments fail.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Health Technology Assessment
Background:
- Uncontrolled hypertension poses significant risks for cardiovascular disease, stroke, kidney failure, and mortality.
- Renal denervation, a minimally invasive procedure, targets renal sympathetic nerves as an adjunctive therapy for resistant hypertension.
- This health technology assessment evaluated renal denervation's effectiveness, safety, cost-effectiveness, budget impact, and patient/provider preferences.
Purpose of the Study:
- To assess the clinical effectiveness and safety of renal denervation for uncontrolled hypertension.
- To determine the cost-effectiveness and budget impact of publicly funding renal denervation.
- To explore patient and provider perspectives on renal denervation as a treatment option.
Main Methods:
- Systematic literature search of randomized controlled trials and systematic reviews.
- Risk of bias assessment using the ROBIS tool.
- Economic evaluation including cost-utility analysis and budget impact modeling.
- Qualitative review of patient and provider preferences and values through interviews.
Main Results:
- Renal denervation significantly lowered systolic blood pressure by 2.1-6.3 mmHg compared to standard care.
- The incremental cost-effectiveness ratio was $121,237 per quality-adjusted life-year (QALY) gained.
- Public funding in Ontario is projected to increase annual costs by $0.42-$3.78 million over 5 years.
- Approximately 30% of patients preferred renal denervation, particularly younger individuals and those with medication adherence issues.
Conclusions:
- Renal denervation is effective in lowering blood pressure for uncontrolled and resistant hypertension.
- While more expensive, it presents a favorable option, especially when conventional treatments fail.
- Patient and provider feedback indicates a positive perception, highlighting its potential as an adjunctive therapy.
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