Key result
Radiofrequency RDN is linked to a sustained ~32 mm Hg systolic BP reduction at 5 years.
Why the study?
Renal denervation is a treatment option for uncontrolled hypertension, but studies evaluating sustained long-term blood pressure reduction are few.
Does radiofrequency renal denervation reduce blood pressure in patients with uncontrolled hypertension?
Cohort (n=83)
No
Does radiofrequency renal denervation reduce blood pressure in patients with uncontrolled hypertension?
Mean Difference: -32 (95% CI -44–-21)
p-value: p=<0.01
Radiofrequency renal denervation provides significant and sustained blood pressure reductions over 5 years in patients with uncontrolled hypertension.
Supports sustained office BP reductions with radiofrequency renal denervation in registry patients; hypothesis-generating and requires randomized confirmation.
Objective: Renal denervation (RDN) is a complementary treatment option for uncontrolled hypertension. Studies on sustained long-term blood pressure (BP) reduction are few. We here report on sustained 5-year BP reductions from the Swedish Registry for Renal Denervation. Design and method: All RDN procedures in Sweden are included in a national registry. We evaluated all 83 patients undergoing radiofrequency RDN in our institution 2011–25 for uncontrolled (resistant or drug intolerance) hypertension. Patients with secondary hypertension, eGFR <30 ml/min/m2, significant valvular disease, recent coronary or cerebrovascular events, pregnancy, or major renal artery abnormalities were ineligible. Follow-up was scheduled at 6, 12, 24, 36, 48, and 60 months. Means ± SD are shown, while linear mixed effects models (adjusted for age and number of antihypertensive drugs) display estimated marginal means with 95% CI. Results: Mean age was 58±13 years, 41% were female, 39% previous and 11% current smokers, 21% had diabetes, 19% chronic kidney disease, 5% heart failure, and 22% coronary artery disease or a previous TIA/stroke. Baseline office BP and average 24-h ABPM were 175±25/95±18 and 153±20/88±15 mm Hg, eGFR 74 ml/min/m2, and number of antihypertensive drugs 3.7±0.3. Changes at 6, 12, 24, 36, 48, and 60 months in office systolic and diastolic BP were -11 [-3;-18], -18 [-11;-26], -24 [-15;-32], -31 [-22;-40], -30 [-20;-40], -32 [-21;-44] and -2 [+3;-7], -6 [-1;-11], -9 [-4;-14], -10 [-4;-15], -10 [-4;-17], -12 [-5;-19] mm Hg for 75, 73, 66, 67, 59, and 54 patients, respectively; and in 24-h ABPM -2 [+3;-12], -14 [-8;-20], -12 [-5;-18], -13 [-6;-21], -7 [+3;-16], -8 [+2;-18] and -1.3 [+3;-3], -7 [-3;-11], -2 [+2;-6], -8 [-3;-13], -7 [-1;-11], -8 [-1;-14] mm Hg for 50, 41 32, 20, 14, and 13 patients, respectively. This indicates sustained 5-year reductions in both systolic and diastolic office and average 24-h ABPM values (all P(overall) <0.01). Number of antihypertensive drugs remained similar throughout, 3.8±0.3 at 60 months. There was a slow progressive decline in eGFR (-9±2 ml/min/m2) at 60 months, however not deemed clinically significant. Conclusions: Radiofrequency RDN offers significant and sustained 5-year BP reductions in patients with uncontrolled hypertension.
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Jekell et al. (2026) conducted a cohort in Uncontrolled hypertension (n=83). Radiofrequency renal denervation was evaluated on Change in office systolic blood pressure at 60 months (MD -32 mm Hg, 95% CI -44 to -21, p=<0.01). Radiofrequency renal denervation provided sustained 5-year reductions in office systolic blood pressure of 32 mm Hg (95% CI -44 to -21; P<0.01) in patients with uncontrolled hypertension.
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