1887
Volume 2014, Issue 1
  • ISSN: 2305-7823
  • E-ISSN:

Abstract

Resistant hypertension is, by definition, a challenge to most physicians treating hypertension. Renal sympathetic denervation has shown promising early results in treating this condition. The SYMPLICITY HTN-3 is the most recent trial to report the effects of this technique on resistant hypertension. This review discusses this study and its surprising neutral results before ending with an overview of key lessons learned.

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/content/journals/10.5339/gcsp.2014.15
2014-07-01
2019-08-18
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References

  1. [1]. Krum   H., , Schlaich   M., , Whitbourn   R., , Sobotka   P., , Sadowski   J., , Bartus   K., , Kapelak   B., , Walton   A., , Sievert   H., , Thambar   S., , Abraham   W., , Esler   M. . Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. . Lancet . 2009; ;373: : 1275– 1281 .
    [Google Scholar]
  2. [2]. Symplicity HTN-2 Investigators., , Esler   MD., , Krum   H., , Sobotka   PA., , Schlaich   MP., , Schmieder   RE., , Böhm   M. . Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. . Lancet . 2010; ;376: : 1903– 1909 .
    [Google Scholar]
  3. [3]. Howard   JP., , Nowbar   AN., , Francis   DP. . Size of blood pressure reduction from renal denervation: insights from meta-analysis of antihypertensive drug trials of 4121 patients with a focus on trial design: the CONVERGE report. . Heart . 2013; ;99: : 1579– 1587 .
    [Google Scholar]
  4. [4]. Bhatt   DL., , Kandzari   DE., , O'Neill   WW., , D'Agostino   R., , Flack   JM., , Katzen   BT., , Leon   MB., , Liu   M., , Mauri   L., , Negoita   M., , Cohen   SA., , Oparil   S., , Rocha-Singh   K., , Townsend   RR., , Bakris   GL., , SYMPLICITY HTN-3 Investigators. . A controlled trial of renal denervation for resistant hypertension. . N Engl J Med . 2014; ;370: : 1393– 1401 .
    [Google Scholar]
  5. [5]. De la Sierra   A., , Segura   J., , Banegas   JR., , Gorostidi   M., , de la Cruz   JJ., , Armario   P., , Oliveras   A., , Ruilope   LM. . Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring. . Hypertension . 2011; ;57: : 898– 902 .
    [Google Scholar]
  6. [6]. Howard   JP., , Cole   GD., , Sievert   H., , Bhatt   DL., , Papademetriou   V., , Kandzari   DE., , Davies   JE., , Francis   DP. . Unintentional overestimation of an expected antihypertensive effect in drug and device trials: mechanisms and solutions. . Int J Cardiol . 2014; ;172: : 29– 35 .
    [Google Scholar]
  7. [7]. Patel   HC., , di Mario   C. . Renal denervation for hypertension: where are we now?.   Br J Cardiol . 2013; ;20: : 142– 147 .
    [Google Scholar]
  8. [8]. Patel   H., , Rosen   S., , Lindsay   A., , Hayward   C., , Lyon   A., , di Mario   C. . Targeting the autonomic nervous system: measuring autonomic function and novel devices for heart failure management. . Int J Cardiol . 2013; ;170: : 107– 117 .
    [Google Scholar]
  9. [9]. Patel   H., , Dhillon   P., , Mahfoud   F., , Lindsay   A., , Hayward   C., , Ersnt   S., , Lyon   A., , Rosen   S., , di Mario   C. . The biophysics of renal sympathetic denervation using radiofrequency energy. . Clin Res Cardiol . 2013; ;103: : 337– 344 .
    [Google Scholar]
  10. [10]. Vaclavik   J., , Sedlak   R., , Plachy   M., , Navratil   K., , Plasek   J., , Jarovsky   J., , Vaclavik   T., , Husar   R., , Kocianova   E., , Taborsky   M. . Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double blind, placebo-controlled trial. . Hypertension . 2011; ;57: : 1069– 1075 .
    [Google Scholar]
  11. [11]. Krum   H., , Schlaich   M., , Sobotka   P., , Bohm   M., , Mahfoud   F., , Rocha-Singh   K., , Katholi   R., , Esler   M. . Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. . Lancet . 2014; ;383: : 622– 629 .
    [Google Scholar]
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  • Article Type: Research Article
Keyword(s): Renal denervation , resistant hypertension and trial design
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