July 13, 2022Open Access
Renal Sympathetic Denervation for Hypertension
Key Result
Renal sympathetic denervation is a safe and well-tolerated endovascular intervention that reliably contributes to improved blood pressure control in patients with arterial hypertension.
Structured PICO
Does renal sympathetic denervation reduce blood pressure in patients with arterial hypertension?
P
Population
Patients with arterial hypertension, including resistant hypertension
I
Intervention
Renal sympathetic denervation (RDN) using catheter-directed techniques (radiofrequency or ultrasound)
C
Comparator
Sham procedure or medical therapy
O
Outcome
Reduction in office or ambulatory blood pressuresurrogate
This review highlights that renal sympathetic denervation is a safe and effective nonpharmacologic adjunct for improving blood pressure control in patients with hypertension.
Limitations
- Need for larger randomized controlled trials with longer follow-ups
- Need for better understanding of patient predictors of blood pressure response
Abstract
Arterial hypertension is the most prevalent global modifiable risk factor for cardiovascular morbidity and mortality. Despite the availability of numerous pharmacologic treatments, many patients do not achieve guideline-recommended blood pressure targets. Therefore, renal sympathetic denervation (RDN), a process in which catheter-directed techniques are used to ablate portions of the renal artery to reduce sympathetic activity, has been extensively investigated as a complementary and nonpharmacologic approach for the treatment of arterial hypertension. This review seeks to discuss the pathophysiological rationale of this strategy, to survey its history and development, and to highlight the current clinical evidence and possible future directions of its employment. In sum, RDN has demonstrated itself to be a safe and well-tolerated endovascular intervention that can reliably contribute to improved blood pressure control and, perhaps ultimately, significant cardiovascular prognosis.