Renal denervation using the Symplicity Spyral system in patients with resistant hypertension reduced 24-hour ambulatory blood pressure from 157/88 mmHg at baseline to 143/83 mmHg at 6 months.
Observational (n=51)
Yes
Does sympathetic renal denervation reduce blood pressure in high-risk patients with resistant hypertension?
Real-world registry data demonstrates that renal denervation yields significant and durable blood pressure reductions in high-risk patients with resistant hypertension.
Objective: Resistant hypertension (rHTN) remains a significant clinical challenge despite multiple therapeutic options. Recently, the Symplicity Spyral system for sympathetic renal denervation (RDN) was introduced. Efficacy data from initial trials have been mixed. To assess real-world effectiveness, we established a registry of RDN procedures performed across centers in Israel. Design and method: Data were collected from six medical centers offering RDN. We analyzed office blood pressure (BP) and ambulatory blood pressure monitoring (ABPM) measurements pre- and post-procedure (at 6 and 12 months). Additional data included comorbidities, antihypertensive medication use, and renal function (GFR). Results: A total of 51 RDN procedures were performed between May 2020 and February 2025. The mean patient age was 60±12 years; 28 (55%) were male. Patients were high-risk with a median of 5±1.2 antihypertensive drugs, and mean GFR was 71±27 mL/min/1.73m2. Comorbidities included diabetes (48%), hyperlipidemia (50%), obesity (28%), TIA/VCA (28%), ischemic heart disease (28%), and atrial fibrillation (22%). Office BP decreased from a baseline of 167/93 mmHg to 159/86 mmHg at 6 months (n=22), and further to 154/83 mmHg at 12 months (n=20). ABPM showed significant reductions: 24-hour BP declined from 157/88 mmHg pre-RDN to 143/83 mmHg at 6 months (n=25), with daytime BP decreasing from 160/89 to 147/85 mmHg, and nighttime BP from 147/79 to 127/69 mmHg. After 12 months there were even slightly better, 24-H 142/80 mmHg, day time 147/83 mmHg and 127/69 at night,(n=19). Follow-up ABPM at approximately 22 months (n=13) demonstrated persistent BP reductions (144/82 mmHg). Conclusions: In carefully selected high-risk patients with true resistant hypertension, renal denervation via Symplicity Spyral yields significant and durable blood pressure reductions. These findings support RDN as a viable intervention in resistant hypertension management.
Leibowitz et al. (Fri,) conducted a observational in Resistant hypertension (n=51). Sympathetic renal denervation (Symplicity Spyral system) was evaluated on Office blood pressure and ambulatory blood pressure monitoring (ABPM). Renal denervation using the Symplicity Spyral system in patients with resistant hypertension reduced 24-hour ambulatory blood pressure from 157/88 mmHg at baseline to 143/83 mmHg at 6 months.