Therapy-resistant hypertension: Renal denervation is a treatment option
Recent studies show the benefit of renal denervation in severe or refractory hypertension. The ESH has started recommending it for some patients.
RDN: Effective treatment, backed with a ESH recommendation
- Since 2018, renal denervation (RDN) has been investigated in several studies and its effectiveness has been proven.
- The ESH therefore gives the procedure a green light for certain patient populations.
- It is important that RDN is performed by a trained multidisciplinary team.
Is renal denervation efficient?
Since 2018, renal denervation has been the subject of numerous studies. Several randomised trials have demonstrated the efficacy of the procedure on hypertension. Not only were the blood pressure levels of the study participants reduced, but the intervention was also safe.
For whom is RDN suitable?
Lifestyle changes, such as diet adaptations, and more exercise, as well as drug therapy still represent the gold standard in the treatment of hypertension. However, these measures do not always lead to successfully reaching the targets hoped for.
If uncontrolled blood pressure levels persist despite lifestyle changes and medication, RDN can be considered, according to the ESH. The same applies if there are contraindications to the administration of antihypertensives. For these patient groups, denervation can achieve the desired reduction in blood pressure.
Making the decision together
However, it is important to involve the patient in the decision-making process. Patients should be informed in detail about the benefits and risks of the intervention. The patient's individual cardiovascular risk, and the expected or existing organ damage due to hypertension must also be considered for any decision.
Furthermore, RDN should only be performed by a well-trained, interdisciplinary team.
New hope for refractory hypertension
RDN is a good treatment option for some hypertension patients. In particular, it is a viable treatment option for refractory hypertension that has not responded to lifestyle changes or drug treatment, or when there is intolerance to antihypertensives.
- Barbato E, Azizi M, Schmieder RE, Lauder L, Böhm M, Brouwers S, Bruno RM, Dudek D, Kahan T, Kandzari DE, Lüscher TF, Parati G, Pathak A, Ribichini FL, Schlaich MP, Sharp ASP, Sudano I, Volpe M, Tsioufis C, Wijns W, Mahfoud F. Renal denervation in the management of hypertension in adults. A clinical consensus statement of the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2023 Apr 17;44(15):1313-1330. Erratum in: Eur Heart J. 2023 Jun 07;: PMID: 36790101.