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Renal sympathetic nerve denervation for the treatment of resistant hypertension

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Long-term safety and durability data for this novel approach to treating resistant hypertension are eagerly awaited

Hypertension is responsible for more deaths and disease than any other cardiovascular risk factor worldwide.1,2 For each 20 mmHg increment in systolic blood pressure (BP) or 10 mmHg increment in diastolic BP, the risk of cardiovascular disease doubles.2,3 Despite lifestyle modification and pharmacotherapy, achieving BP targets poses a significant challenge. Resistant hypertension is BP that remains above target levels in spite of adherence to three antihypertensive agents, one of which should ideally be a diuretic.1 The United States prevalence of resistant hypertension of 8.9%, reported in the National Health and Nutrition Examination Survey (2003–2008), is likely to be an underestimate.4,5 A promising alternative treatment modality for resistant hypertension — renal sympathetic denervation (renal denervation; RDN) — has recently been developed.

The procedure

Numerous RDN devices are currently under development, and most use an endovascular catheter-based approach to ablate renal…