New Literature Review selected in HEART by Sebastian Ewen

 Percutaneous renal denervation: new treatment option for resistant hypertension and more?

  • Authors: Sebastian Ewen, Christian Ukena, Michael Böhm, Felix Mahfoud
  • Reference: Heart 2013;0:1–6.
  • Published: 6 March 2013
  • Link: Access abstract here

 My comment by Sebastian Ewen

 

Renal denervation

    • is a new promising treatment method for resistant arterial hypertension.
    • reduces blood pressure and increases blood pressure control rates.
    • might positively influence other cardiovascular morbidities, characterized by increased sympathetic activity, including hyperinsulinemia, obstructive sleep apnea syndrome, left ventricular hypertrophy, and diastolic dysfunction.

The following criteria should be fulfilled before a patient is considered for renal denervation:

    • SBP ≥160 mmHg (≥150 mmHg diabetes type 2)
    • ≥3 antihypertensive drugs in adequate dosage and combination (incl. diuretic)
    • Life-style modification
    • Exclusion of secondary hypertension
    • Exclusion of pseudo-resistance (ABPM)
    • Preserved renal function (eGFR ≥45 ml/min/1,73 m2)
    • Eligible renal arteries: no stenosis, no PTA/stenting

Clinical trials and registries with prolonged follow-up periods are required to assess the durability and safety of renal denervation over time.

Numerous new catheter systems and treatment modalities are in development.

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