Key result
Renal denervation for therapy-resistant hypertension showed no significant benefit compared to a sham procedure in recent randomized trials, and all invasive procedures should currently be restricted to studies or registries.
Why the study?
Do invasive treatment methods like renal denervation and baroreceptor activator therapy improve outcomes in patients with therapy-resistant hypertension compared to sham procedures or intensified drug therapy?
Do invasive treatment methods like renal denervation and baroreceptor activator therapy improve outcomes in patients with therapy-resistant hypertension compared to sham procedures or intensified drug therapy?
Current evidence does not support the routine use of renal denervation over sham or intensified medical therapy for resistant hypertension, and all invasive procedures should remain investigational.
Questions renal denervation for resistant hypertension; leaves open its role after negative blinded RCTs.
Invasive treatment methods-more specifically renal denervation and baroreceptor activator therapy-have been used for the treatment of therapy-resistant hypertension for several years now. In particular, renal denervation has aroused great interest because it was easy to perform and the first studies provided very promising results. Meanwhile, however, three randomized, blinded studies have been published, and none showed a significant benefit of renal denervation compared to a sham procedure. In addition, in several studies it was demonstrated that intensification of drug therapy, particularly with spironolactone, is at least comparable. Carotid sinus node baroreceptor activator therapy tends to be superior to renal denervation, but the probe currently used is not optimal. The first results by inserting an arteriovenous shunt between the iliac artery and vein are promising, but lack long-term safety data. Currently, all invasive treatment procedures should be performed within the framework of studies or accurate register surveys.
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Menne et al. (2016) conducted a review in Therapy-resistant hypertension. Invasive treatment methods (renal denervation, baroreceptor activator therapy) vs. Sham procedure or drug therapy was evaluated. Renal denervation for therapy-resistant hypertension showed no significant benefit compared to a sham procedure in recent randomized trials, and all invasive procedures should currently be restricted to studies or registries.
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