The position of renal denervation in treatment of hypertension: an expert consensus statement

V J M Zeijen; A A Kroon; B H van den Born; P J Blankestijn; S C A Meijvis; A Nap; E Lipsic; A Elvan; J Versmissen; R J van Geuns; M Voskuil; P A L Tonino; W Spiering; J Deinum; J Daemen

doi:10.1007/s12471-022-01717-4

The position of renal denervation in treatment of hypertension: an expert consensus statement

V J M Zeijen, A A Kroon, B H van den Born, P J Blankestijn, S C A Meijvis, A Nap, E Lipsic, A Elvan, J Versmissen, R J van Geuns, M Voskuil, P A L Tonino, W Spiering, J Deinum, J Daemen^*

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Hypertension is an important risk factor for cardiovascular disease. In the Netherlands, there are approximately 2.8 million people with hypertension. Despite treatment recommendations including lifestyle changes and antihypertensive drugs, most patients do not meet guideline-recommended blood pressure (BP) targets. In order to improve BP control and lower the risk of subsequent cardiovascular events, renal sympathetic denervation (RDN) has been introduced and studied as a non-pharmacological approach. While early data on the efficacy of RDN showed conflicting results, improvements in treatment protocols and study design resulted in robust new evidence supporting the potential of the technology to improve patient care in hypertensive subjects. Recently, 5 randomised sham-controlled trials demonstrated the safety and efficacy of the technology. Modelling studies have further shown that RDN is cost-effective in the Dutch healthcare setting. Given the undisputable disease burden along with the shortcomings of current therapeutic options, we postulate a new, clearly framed indication for RDN as an adjunct in the treatment of hypertension. The present consensus statement summarises current guideline-recommended BP targets, proposed workup and treatment for hypertension, and position of RDN for those patients with primary hypertension who do not meet guideline-recommended BP targets (see central illustration).

Original language	English
Pages (from-to)	3-11
Number of pages	9
Journal	Netherlands Heart Journal
Volume	31
Issue number	1
Early online date	24 Aug 2022
DOIs	https://doi.org/10.1007/s12471-022-01717-4
Publication status	Published - Jan 2023

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Cite this

Zeijen, V. J. M., Kroon, A. A., van den Born, B. H., Blankestijn, P. J., Meijvis, S. C. A., Nap, A., Lipsic, E., Elvan, A., Versmissen, J., van Geuns, R. J., Voskuil, M., Tonino, P. A. L., Spiering, W., Deinum, J., & Daemen, J. (2023). The position of renal denervation in treatment of hypertension: an expert consensus statement. Netherlands Heart Journal, 31(1), 3-11. https://doi.org/10.1007/s12471-022-01717-4

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title = "The position of renal denervation in treatment of hypertension: an expert consensus statement",

abstract = "Hypertension is an important risk factor for cardiovascular disease. In the Netherlands, there are approximately 2.8 million people with hypertension. Despite treatment recommendations including lifestyle changes and antihypertensive drugs, most patients do not meet guideline-recommended blood pressure (BP) targets. In order to improve BP control and lower the risk of subsequent cardiovascular events, renal sympathetic denervation (RDN) has been introduced and studied as a non-pharmacological approach. While early data on the efficacy of RDN showed conflicting results, improvements in treatment protocols and study design resulted in robust new evidence supporting the potential of the technology to improve patient care in hypertensive subjects. Recently, 5 randomised sham-controlled trials demonstrated the safety and efficacy of the technology. Modelling studies have further shown that RDN is cost-effective in the Dutch healthcare setting. Given the undisputable disease burden along with the shortcomings of current therapeutic options, we postulate a new, clearly framed indication for RDN as an adjunct in the treatment of hypertension. The present consensus statement summarises current guideline-recommended BP targets, proposed workup and treatment for hypertension, and position of RDN for those patients with primary hypertension who do not meet guideline-recommended BP targets (see central illustration).",

author = "Zeijen, {V J M} and Kroon, {A A} and {van den Born}, {B H} and Blankestijn, {P J} and Meijvis, {S C A} and A Nap and E Lipsic and A Elvan and J Versmissen and {van Geuns}, {R J} and M Voskuil and Tonino, {P A L} and W Spiering and J Deinum and J Daemen",

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year = "2023",

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doi = "10.1007/s12471-022-01717-4",

language = "English",

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Zeijen, VJM, Kroon, AA, van den Born, BH, Blankestijn, PJ, Meijvis, SCA, Nap, A, Lipsic, E, Elvan, A, Versmissen, J, van Geuns, RJ, Voskuil, M, Tonino, PAL, Spiering, W, Deinum, J & Daemen, J 2023, 'The position of renal denervation in treatment of hypertension: an expert consensus statement', Netherlands Heart Journal, vol. 31, no. 1, pp. 3-11. https://doi.org/10.1007/s12471-022-01717-4

TY - JOUR

T1 - The position of renal denervation in treatment of hypertension

T2 - an expert consensus statement

AU - Zeijen, V J M

AU - Kroon, A A

AU - van den Born, B H

AU - Blankestijn, P J

AU - Meijvis, S C A

AU - Nap, A

AU - Lipsic, E

AU - Elvan, A

AU - Versmissen, J

AU - van Geuns, R J

AU - Voskuil, M

AU - Tonino, P A L

AU - Spiering, W

AU - Deinum, J

AU - Daemen, J

PY - 2023/1

Y1 - 2023/1

N2 - Hypertension is an important risk factor for cardiovascular disease. In the Netherlands, there are approximately 2.8 million people with hypertension. Despite treatment recommendations including lifestyle changes and antihypertensive drugs, most patients do not meet guideline-recommended blood pressure (BP) targets. In order to improve BP control and lower the risk of subsequent cardiovascular events, renal sympathetic denervation (RDN) has been introduced and studied as a non-pharmacological approach. While early data on the efficacy of RDN showed conflicting results, improvements in treatment protocols and study design resulted in robust new evidence supporting the potential of the technology to improve patient care in hypertensive subjects. Recently, 5 randomised sham-controlled trials demonstrated the safety and efficacy of the technology. Modelling studies have further shown that RDN is cost-effective in the Dutch healthcare setting. Given the undisputable disease burden along with the shortcomings of current therapeutic options, we postulate a new, clearly framed indication for RDN as an adjunct in the treatment of hypertension. The present consensus statement summarises current guideline-recommended BP targets, proposed workup and treatment for hypertension, and position of RDN for those patients with primary hypertension who do not meet guideline-recommended BP targets (see central illustration).

AB - Hypertension is an important risk factor for cardiovascular disease. In the Netherlands, there are approximately 2.8 million people with hypertension. Despite treatment recommendations including lifestyle changes and antihypertensive drugs, most patients do not meet guideline-recommended blood pressure (BP) targets. In order to improve BP control and lower the risk of subsequent cardiovascular events, renal sympathetic denervation (RDN) has been introduced and studied as a non-pharmacological approach. While early data on the efficacy of RDN showed conflicting results, improvements in treatment protocols and study design resulted in robust new evidence supporting the potential of the technology to improve patient care in hypertensive subjects. Recently, 5 randomised sham-controlled trials demonstrated the safety and efficacy of the technology. Modelling studies have further shown that RDN is cost-effective in the Dutch healthcare setting. Given the undisputable disease burden along with the shortcomings of current therapeutic options, we postulate a new, clearly framed indication for RDN as an adjunct in the treatment of hypertension. The present consensus statement summarises current guideline-recommended BP targets, proposed workup and treatment for hypertension, and position of RDN for those patients with primary hypertension who do not meet guideline-recommended BP targets (see central illustration).

U2 - 10.1007/s12471-022-01717-4

DO - 10.1007/s12471-022-01717-4

M3 - (Systematic) Review article

C2 - 36001280

SN - 1568-5888

VL - 31

SP - 3

EP - 11

JO - Netherlands Heart Journal

JF - Netherlands Heart Journal

IS - 1

ER -