Breaking the Cycle : Ultrasound's Novel Approach to Renal Denervation and Hypertension Relief

Maged Naser, Mohamed M. Nasr, Lamia H. Shehata

Abstract


   Several device-based treatments exist for high blood pressure (1). Catheter-based renal denervation (RDN) has the most supporting evidence (2). RDN lowers blood pressure by affecting the sympathetic nervous system. It disrupts nerve signals in the renal arteries. Early studies on RDN showed great promise. Patients with hard-to-treat hypertension saw big blood pressure drops (12). This excitement faded after the Symplicity HTN-3 trial. This study showed RDN was safe. However, it did not lower blood pressure better than a sham procedure. Early sham-controlled trials gave key insights into trial design. Reviews of these trials and new nerve findings helped improve RDN. Better catheter systems were also created. These advances led to second-generation sham-controlled trials. The European Society of Cardiology (ESC) and European Association of Percutaneous Cardiovascular Interventions (EAPCI) have set quality standards for RDN trials. High-quality trials should be sham-controlled and multicentre. They need proper blinding and use ambulatory blood pressure as the main outcome. Studies must be completed as planned. Second-generation RDN systems and techniques should be used. This review will discuss why RDN is used. It will also summarise results from recent second-generation trials.


Keywords


Blood Pressure, Cardiovascular Disease, Hypertension, Interventional Cardiology, Renal Denervation, Vascular Medicine.

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References


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DOI: http://dx.doi.org/10.52155/ijpsat.v50.1.7117

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