Long-Term Safety and Antihypertensive Effects of Renal Denervation: Current Insights

Abstract

Hypertension is the most potent modifiable risk factor for the development of cardiovascular morbidity and mortality worldwide. Nevertheless, blood pressure (BP) control on a broad scale appears to be insurmountable and has even worsened in the US. Barriers to sustained hypertension control are multifactorial and although lack of patient awareness and socioeconomic barriers to healthcare access may play a role, medication non-compliance and therapeutic inertia are major causes. Renal denervation (RDN) is a minimally invasive procedure that has been the subject of interest in clinical trials for more than a decade and although the first sham-controlled trial could not detect group difference between treated and untreated hypertensives, subsequent, better designed sham-controlled trials clearly demonstrated the BP lowering effect of RDN, as well as its safety. While to-date, RDN is not available for routine clinical practice, one major requirement for broad implementation is that the BP lowering effect is durable. Therefore, this review will summarize the available long-term data of the different RDN modalities with respect to both effectiveness and safety.

Sympathetic Pathophysiology in Hypertension Origins: The Path to Renal Denervation

“…68 Further results from long-term observational follow-up studies have been published [81][82][83] consistently confirming a durable BP-lowering effect without major safety concerns following RDN out to 10 years of follow-up. Average BP reduction in trials with short-and long-term BP assessment were recently compared 84 and are summarized in Figure 5. Although currently available data suggest a long-term benefit of RDN both in terms of BP-lowering and potential ancillary effects, this remains to be formally demonstrated.…”