Efficacy and safety of sympathetic mapping and ablation of renal nerves for the treatment of hypertension (SMART): 6-month follow-up of a randomised, controlled trial

Wang, Jie; Yin, Yuehui; Lu, Chengzhi; Lu, Zhibing; Hu, Jialu; Wang, Yue; Ge, Junbo; Jiang, Hong; Yao, Chen; Yan, Xiaoyan; Ma, Wei; Qi, Xiaoyong; Dang, Yi; Chen, Shaoliang; Zhu, Jiancheng; Wang, Dongmei; Ding, Chao; Wang, Weimin; Liu, Jian; Wang, Yanbin; Li, Hui; Pan, Zhenhua; Cui, Kaijun; Li, Chengzong; Liang, Xinjian; Chen, Weijie; Sobotka, Paul A.; Zhang, JingJing; Esler, Murray; Sun, Ningling; Chen, Minglong; Huo, Yong

doi:10.1016/j.eclinm.2024.102626

eClinicalMedicine

2024

DOI: 10.1016/j.eclinm.2024.102626

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Efficacy and safety of sympathetic mapping and ablation of renal nerves for the treatment of hypertension (SMART): 6-month follow-up of a randomised, controlled trial

Jie Wang,

Yuehui Yin,

Chengzhi Lu

et al.

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Cited by 2 publications

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The road to renal denervation for hypertension and beyond (HF): two decades of failed, succeeded, and to be determined

Jiang,

Kittipibul,

Mahfoud

et al. 2024

Heart Fail Rev

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The road to renal denervation for hypertension and beyond (HF): two decades of failed, succeeded, and to be determined

Jiang,

Kittipibul,

Mahfoud

et al. 2024

Heart Fail Rev

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Medication Changes After Renal Denervation: Current Evidence and Patient Perspectives

Zhang,

Zhao,

et al. 2024

JAHA

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Renal denervation (RDN) is recognized as an adjunct therapy for hypertension management with a favorable and consistent blood pressure–lowering efficacy and safety profile. Alteration in medication burden is another noteworthy outcome of RDN for clinicians and patients. In this review, we summarized current clinical trials and patient perspectives, focusing on the use of antihypertensive medication (AHM) after RDN. The results of randomized controlled trials demonstrated that patients undergoing RDN exhibited lower blood pressure levels with a similar AHM burden or similar blood pressure levels with fewer AHMs than the sham control group. In studies with follow‐ups of ≤6 months, AHM use increased or remained generally consistent in patients undergoing RDN, which may be attributed to the prespecified study process. In studies with follow‐ups of >6 months, the blood pressure–lowering efficacy of RDN was consistent with a decreasing or similar AHM burden compared with baseline conditions, except for the 36‐month results in the SPYRAL HTN‐ON MED (Safety and Efficacy of Renal Denervation in Patients Taking Antihypertensive Medications) trial. Huge gaps exist between current evidence on medication changes after RDN and patient expectations, which may be addressed through adequate communication in a shared decision‐making process and further improvement of the RDN procedure. Moreover, novel evaluation methodologies for assessing medication burden changes, incorporating adherence to AHMs and modifications in drug classes, may be required to evaluate the impact of RDN on medication usage in the future.

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Efficacy and safety of sympathetic mapping and ablation of renal nerves for the treatment of hypertension (SMART): 6-month follow-up of a randomised, controlled trial

Cited by 2 publications

References 54 publications

The road to renal denervation for hypertension and beyond (HF): two decades of failed, succeeded, and to be determined

The road to renal denervation for hypertension and beyond (HF): two decades of failed, succeeded, and to be determined

Medication Changes After Renal Denervation: Current Evidence and Patient Perspectives

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