Key result
Renal nerve ablation, baroreceptor stimulation, and peripheral arterial venous anastomosis are reviewed as interventional approaches for the treatment of resistant hypertension.
Why the study?
Do interventional approaches (renal nerve ablation, baroreceptor stimulation, peripheral arterial venous anastomosis) reduce blood pressure in patients with treatment-resistant hypertension?
Do interventional approaches (renal nerve ablation, baroreceptor stimulation, peripheral arterial venous anastomosis) reduce blood pressure in patients with treatment-resistant hypertension?
This review summarizes the rationale and clinical results of interventional therapies (renal nerve ablation, baroreceptor stimulation, AV anastomosis) for treatment-resistant hypertension.
Interventional approaches for resistant hypertension should not yet change practice; leaves open the need for definitive randomized trials.
Treatment-resistant hypertension, or resistant hypertension, is defined as blood pressure that remains above target despite concurrent use of at least three antihypertensive agents from different classes at optimal doses, one of which should be a diuretic. Important considerations in the diagnosis of treatment-resistant hypertension include the exclusion of pseudoresistance and the evaluation of potential secondary causes of hypertension and of concomitant conditions that maintain high blood pressure. The ability to diagnose true treatment-resistant hypertension is important for selection of patients who may be appropriately treated with an invasive therapy. Currently, there are three interventional approaches to treat resistant hypertension, namely: (1) reduction of the activity of the sympathetic nervous system by renal nerve ablation, (2) stimulation of baroreceptors and (3) creation of a peripheral arterial venous anastomosis. This review focuses on the rationale behind these invasive approaches and the clinical results.
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Erné et al. (2016) conducted a review in Treatment-resistant hypertension. Interventional approaches (renal nerve ablation, baroreceptor stimulation, peripheral arterial venous anastomosis) was evaluated. Renal nerve ablation, baroreceptor stimulation, and peripheral arterial venous anastomosis are reviewed as interventional approaches for the treatment of resistant hypertension.
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