What is the clinical evidence from this study?

Study design: Review. Population: Hypertension. Intervention: Catheter-based renal denervation.

What question did this study set out to answer?

The review aims to discuss advancements in renal denervation techniques and their effectiveness in managing difficult hypertension.

June 11, 2026Open Access

Recent advances in the approach to catheter-based renal denervation

Key Result

Catheter-based renal denervation results in a clinically relevant and durable blood pressure reduction in patients with difficult-to-control and resistant hypertension.

Key Points

The review aims to discuss advancements in renal denervation techniques and their effectiveness in managing difficult hypertension.
Non-systematic review conducted on Medline and Scopus from June 2025 to March 2026.
Overview of the development and refinement of renal denervation techniques.
Discussion on patient selection and conditions benefiting from renal denervation.
Renal denervation has shown clinically relevant and durable reductions in blood pressure.
The procedure demonstrates a favorable safety profile.
Novel RDN systems employing ultrasound and chemical methods show promise in the field.

Structured PICO

Does catheter-based renal denervation reduce blood pressure in patients with difficult-to-control and resistant hypertension?

Population

Patients with difficult-to-control and resistant hypertension

Intervention

Catheter-based renal denervation (RDN)

Outcome

Blood pressure reductionsurrogate

Catheter-based renal denervation is a safe and effective interventional approach for durable blood pressure reduction in resistant hypertension.

Limitations

Lack of direct head-to-head comparisons between traditional ablation strategies and those informed by renal nerve stimulation
Further investigation in larger, randomized, sham-control trials is required to definitively assess benefits for conditions like heart failure and chronic kidney disease

Abstract

INTRODUCTION: Renal denervation is an interventional approach for the reduction of blood pressure with sustained and clinically relevant outcomes in clinical trials. Ablation of the renal nerves reduces sympathetic efferent and sensory afferent nerve traffic responsible for BP elevation. AREAS COVERED: This review provides an overview of hypertension pathophysiology, the development and ongoing refinement of renal denervation techniques, as well as the role of patient selection for outcomes and other conditions which may benefit from RDN. A non-systematic review of Medline and Scopus was performed from 1 June 2025 to 1 March 2026. EXPERT OPINION: Sham-controlled clinical trials have proven that RDN results in a clinically relevant and durable blood pressure reduction in patients with difficult-to-control and resistant hypertension, either on or off concomitant antihypertensive treatment. The procedure has a favorable safety profile. The introduction of novel RDN systems utilizing ultrasound ablation and chemically mediated denervation has continued to advance the field and further corroborate the principles of RDN. Whether there is superiority of a particular systems remains an open question and will be an ongoing research focus. Procedural improvements and the role of renal nerve stimulation to guide subsequent ablation show promise to further enhance outcomes for patients.