Messerli, Franz H;
Bavishi, Chirag;
Brguljan, Jana;
Burnier, Michel;
Dobner, Stephan;
Elijovich, Fernando;
Ferdinand, Keith C;
... Williams, Bryan; + view all
(2022)
Renal denervation in the antihypertensive arsenal - knowns and known unknowns.
Journal of Hypertension
, 40
(10)
pp. 1859-1875.
10.1097/HJH.0000000000003171.
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Abstract
Even though it has been more than a decade since renal denervation (RDN) was first used to treat hypertension and an intense effort on researching this therapy has been made, it is still not clear how RDN fits into the antihypertensive arsenal. There is no question that RDN lowers blood pressure (BP), it does so to an extent at best corresponding to one antihypertensive drug. The procedure has an excellent safety record. However, it remains clinically impossible to predict whose BP responds to RDN and whose does not. Long-term efficacy data on BP reduction are still unconvincing despite the recent results in the SPYRAL HTN-ON MED trial; experimental studies indicate that reinnervation is occurring after RDN. Although BP is an acceptable surrogate endpoint, there is complete lack of outcome data with RDN. Clear indications for RDN are lacking although patients with resistant hypertension, those with documented increase in activity of the sympathetic system and perhaps those who desire to take fewest medication may be considered.
| Type: | Article |
|---|---|
| Title: | Renal denervation in the antihypertensive arsenal - knowns and known unknowns |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/HJH.0000000000003171 |
| Publisher version: | https://doi.org/10.1097/HJH.0000000000003171 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons License. See: http://creativecommons.org/licenses/by-nc-nd/4.0 |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Peripheral Vascular Disease, Cardiovascular System & Cardiology, antihypertensive treatment, blood pressure, hypertension, refractory hypertension, renal denervation, TREATMENT-RESISTANT HYPERTENSION, AMBULATORY BLOOD-PRESSURE, OBSTRUCTIVE SLEEP-APNEA, PAROXYSMAL ATRIAL-FIBRILLATION, BAROREFLEX ACTIVATION THERAPY, CHRONIC KIDNEY-DISEASE, SYMPATHETIC DENERVATION, SYMPLICITY HTN-3, HEART-FAILURE, UNCONTROLLED HYPERTENSION |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10167533 |
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