European Society of Hypertension position paper on renal denervation 2018

Roland E. Schmieder*, Felix Mahfoud, Michel Azizi, Atul Pathak, Kyriakos Dimitriadis, Abraham A. Kroon, Christian Ott, Filippo Scalise, Giuseppe Mancia, Costas Tsioufis, ESH Working Group on Interventional Treatment of Hypertension

*Corresponding author for this work

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Abstract

This ESH update was deemed necessary with the publication of new results of sham-controlled randomized blinded prospective trials with renal denervation (RDN). Proof of concept studies and first randomized trials (some were sham-controlled) displayed discrepant results about the efficacy of RDN. Three sham-controlled randomized trials of the 2.0 generation yielded now similarity in the average blood pressure decrease following RDN. Reduction of ambulatory blood pressure was approximately 5 to 7 mmHg and of office blood pressure 10 mmHg. Such a decrease in blood pressure by pharmacologic therapy has been found to be associated with lower incidence of cardiovascular events in particular with respect to heart failure and stroke by roughly 25%. Nevertheless, some questions about renal denervation are unanswered. The heterogeneity of the blood pressure-lowering response point to the clinical need to identify predictors for efficacy, and questions on long-term safety could not have been answered due to the short duration of the sham-controlled randomized clinical trials.

Original languageEnglish
Pages (from-to)2042-2048
Number of pages7
JournalJournal of Hypertension
Volume36
Issue number10
DOIs
Publication statusPublished - Oct 2018

Keywords

  • hypertension
  • renal nerves
  • renal denervation
  • randomized controlled trial
  • TREATMENT-RESISTANT HYPERTENSION
  • BLOOD-PRESSURE
  • SYMPATHETIC DENERVATION
  • SYMPLICITY HTN-3
  • ANTIHYPERTENSIVE TREATMENT
  • CONTROLLED-TRIAL
  • REDUCTION

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