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Renal denervation in the antihypertensive arsenal – knowns and known unknowns

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...

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Autores principales: Messerli, Franz H., Bavishi, Chirag, Brguljan, Jana, Burnier, Michel, Dobner, Stephan, Elijovich, Fernando, Ferdinand, Keith C., Kjeldsen, Sverre, Laffer, Cheryl L., S Ram, C. Venkata, Rexhaj, Emrush, Ruilope, Luis M., Shalaeva, Evgeniya V., Siontis, George C.M., Staessen, Jan A., Textor, Stephen C., Vongpatanasin, Wanpen, Vogt, Liffert, Volpe, Massimo, Wang, Jiguang, Williams, Bryan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010701/
https://www.ncbi.nlm.nih.gov/pubmed/36052518
http://dx.doi.org/10.1097/HJH.0000000000003171
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author Messerli, Franz H.
Bavishi, Chirag
Brguljan, Jana
Burnier, Michel
Dobner, Stephan
Elijovich, Fernando
Ferdinand, Keith C.
Kjeldsen, Sverre
Laffer, Cheryl L.
S Ram, C. Venkata
Rexhaj, Emrush
Ruilope, Luis M.
Shalaeva, Evgeniya V.
Siontis, George C.M.
Staessen, Jan A.
Textor, Stephen C.
Vongpatanasin, Wanpen
Vogt, Liffert
Volpe, Massimo
Wang, Jiguang
Williams, Bryan
author_facet Messerli, Franz H.
Bavishi, Chirag
Brguljan, Jana
Burnier, Michel
Dobner, Stephan
Elijovich, Fernando
Ferdinand, Keith C.
Kjeldsen, Sverre
Laffer, Cheryl L.
S Ram, C. Venkata
Rexhaj, Emrush
Ruilope, Luis M.
Shalaeva, Evgeniya V.
Siontis, George C.M.
Staessen, Jan A.
Textor, Stephen C.
Vongpatanasin, Wanpen
Vogt, Liffert
Volpe, Massimo
Wang, Jiguang
Williams, Bryan
author_sort Messerli, Franz H.
collection PubMed
description 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.
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spelling pubmed-100107012023-03-14 Renal denervation in the antihypertensive arsenal – knowns and known unknowns Messerli, Franz H. Bavishi, Chirag Brguljan, Jana Burnier, Michel Dobner, Stephan Elijovich, Fernando Ferdinand, Keith C. Kjeldsen, Sverre Laffer, Cheryl L. S Ram, C. Venkata Rexhaj, Emrush Ruilope, Luis M. Shalaeva, Evgeniya V. Siontis, George C.M. Staessen, Jan A. Textor, Stephen C. Vongpatanasin, Wanpen Vogt, Liffert Volpe, Massimo Wang, Jiguang Williams, Bryan J Hypertens Reviews 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. Lippincott Williams & Wilkins 2023-03-07 2022-10 /pmc/articles/PMC10010701/ /pubmed/36052518 http://dx.doi.org/10.1097/HJH.0000000000003171 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Reviews
Messerli, Franz H.
Bavishi, Chirag
Brguljan, Jana
Burnier, Michel
Dobner, Stephan
Elijovich, Fernando
Ferdinand, Keith C.
Kjeldsen, Sverre
Laffer, Cheryl L.
S Ram, C. Venkata
Rexhaj, Emrush
Ruilope, Luis M.
Shalaeva, Evgeniya V.
Siontis, George C.M.
Staessen, Jan A.
Textor, Stephen C.
Vongpatanasin, Wanpen
Vogt, Liffert
Volpe, Massimo
Wang, Jiguang
Williams, Bryan
Renal denervation in the antihypertensive arsenal – knowns and known unknowns
title Renal denervation in the antihypertensive arsenal – knowns and known unknowns
title_full Renal denervation in the antihypertensive arsenal – knowns and known unknowns
title_fullStr Renal denervation in the antihypertensive arsenal – knowns and known unknowns
title_full_unstemmed Renal denervation in the antihypertensive arsenal – knowns and known unknowns
title_short Renal denervation in the antihypertensive arsenal – knowns and known unknowns
title_sort renal denervation in the antihypertensive arsenal – knowns and known unknowns
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010701/
https://www.ncbi.nlm.nih.gov/pubmed/36052518
http://dx.doi.org/10.1097/HJH.0000000000003171
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