Hypertension is a global problem affecting approximately 1 billion people (2000 estimate) and this number is set to increase by a further 500 million by 2025. Although frequently a ‘silent’ disease, hypertension is associated with the development of cardiovascular risk factors. Pharmacological management forms the mainstay of treatment but treatment resistant hypertension (blood pressure above desired range despite three concurrent anti-hypertensives one of which should be a diuretic) is a common problem and challenging for clinicians to manage. Renal sympathetic denervation has been proposed as a treatment option in these cases. Since 2007, over 4000 patients have undergone the procedure using the Medtronic (formerly Ardian) Symplicity renal denervation system (click here for the Which Medical Device overview of this and other newer devices). This editorial reviews the rationale, evidence, complications and future implications of renal sympathetic denervation (RSD).
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