Renal denervation triage tool: a practical approach to the management of resistant hypertension

Despite the availability of medications and advocacy for lifestyle interventions, over half of individuals with hypertension do not achieve recommended treatment goals owing to limitations with medications, such as high cost, side effects, and poor adherence. Renal denervation (RDN), a minimally invasive endovascular procedure targeting sympathetic nerves near the renal arteries, is gaining recognition as a safe and effective adjunctive therapy for blood pressure control in resistant hypertension, supported by several clinical trials and meta-analyses. Recognising the clinical complexity of resistant hypertension, a group of hypertension experts from India convened to develop an "RDN triage tool" to guide clinicians in selecting appropriate candidates for RDN therapy based on demographics, blood pressure, renal function, and cardiac status. This approach is supported by clinical evidence and expert recommendations and aims to optimise patient selection for RDN therapy, aid clinical decision-making, minimise risks, and enhance patient outcomes.