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

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.

Loading

Article metrics loading...

/content/journals/10.5339/gcsp.2014.15
2014-07-01
2020-10-27
Loading full text...

Full text loading...

/deliver/fulltext/gcsp/2014/1/gcsp.2014.15.html?itemId=/content/journals/10.5339/gcsp.2014.15&mimeType=html&fmt=ahah

References

  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::12751281.
    [Google Scholar]
  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::19031909.
    [Google Scholar]
  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::15791587.
    [Google Scholar]
  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::13931401.
    [Google Scholar]
  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::898902.
    [Google Scholar]
  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::2935.
    [Google Scholar]
  7. Patel HC, di Mario C. Renal denervation for hypertension: where are we now? Br J Cardiol. 2013; 20::142147.
    [Google Scholar]
  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::107117.
    [Google Scholar]
  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::337344.
    [Google Scholar]
  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::10691075.
    [Google Scholar]
  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::622629.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/gcsp.2014.15
Loading
/content/journals/10.5339/gcsp.2014.15
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): Renal denervation , resistant hypertension and trial design
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error