Can renal denervation replace medications for patients with hypertension?

Hypertension is a leading cause of death worldwide and a major modifiable risk factor for cardiovascular disease and chronic kidney disease. 1 Mills KT Stefanescu A He J The global epidemiology of hypertension. Nat Rev Nephrol. 2020; 16: 223-237 Google Scholar Over the past decade, guidelines have evolved to recommend more stringent blood pressure control. 2 Whelton PK Carey RM Aronow WS et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; 71: 1269-1324 Google Scholar However, achieving this control often requires multi-drug regimens and is limited by non-adherence, dosing complexity, drug intolerance, and expense. Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trialRadiofrequency renal denervation compared with sham control produced a clinically meaningful and lasting blood pressure reduction up to 36 months of follow-up, independent of concomitant antihypertensive medications and without major safety events. Renal denervation could provide an adjunctive treatment modality in the management of patients with hypertension. Full-Text PDF