Proceedings from the European clinical consensus conference for renal denervation: Considerations on future clinical trial design

摘要

Introduction: Approximately 8-18% of all patients with high blood pressure (BP) are apparently resistant to drug treatment.1'2 In this situation, new strategies to help reduce BP are urgently needed but the complex pathophysiology of resistant hypertension makes this search difficult. Not surprisingly in this context, the latest non-drug treatment which triggered controversy is catheter-based renal denervation (RDN). The method uses radiofrequency energy, or alternatively ultrasound or chemical denervation, to disrupt renal nerves within the renal artery wall, thereby reducing sympathetic efferent and sensory afferent signalling to and from the kidneys. Various experimental models of hypertension strongly support this concept and available evidence also suggests that sympathetic nervous system activation contributes to the development and progression of hypertension and subsequently to target organ damage.