Renal Sympathetic Denervation Therapy for Resistant Hypertension

Joint British Societies’ consensus recommendations for the prevention of cardiovascular disease (JBS3)

“…Renal denervation has emerged as a potential treatment strategy for true resistant hypertension 233 234. Data on the safety and efficacy of this technique suggest that the initial findings relating to efficacy may have been exaggerated.…”

Diagnosis and management of resistant hypertension

“…Increased sympathetic outflow has been implicated in resistant hypertension and renal denervation has been proposed as an effective method of interrupting sympathetic supply to the kidney resulting in reduced blood pressure 34. Renal denervation involves disruption of renal sympathetic nerves along the renal artery by radio-ablation catheters inserted through the femoral artery 34…”

High rates of non-adherence to antihypertensive treatment revealed by high-performance liquid chromatography-tandem mass spectrometry (HP LC-MS/MS) urine analysis

“…Poor concordance with treatment is considered to be one of the major causes of inadequate response to blood pressure (BP) lowering treatment in patients diagnosed with ‘resistant hypertension’ (up to 10%–20% of patients with high BP) 2. This issue has recently come to the fore because of the availability of new non-drug therapies, that is, percutaneous radiofrequency, catheter-based renal sympathetic denervation (renal denervation) for patients with suspected resistance to antihypertensive treatment 2 3. Furthermore, patients with undeclared/unrecognised non-adherence frequently undergo numerous additional (sometimes invasive and often expensive) diagnostic tests in specialist centres to identify causes of their apparent poor response to antihypertensive medications.…”