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Renal denervation: a new therapeutic approach for resistant hypertension

摘要Objective To review the advances in studies on renal denervation.Data sources References concerning renal denervation and resistant hypertension cited in this review were collected from PubMed published in English and those of renal denervation devices from official websites of device manufacturers up to January 2014.Study selection Articles with keywords "renal denervation" and "resistant hypertension" were selected.Results Renal and systemic sympathetic overactivity plays an important role in pathology of hypertension as well as other diseases characterized by sympathetic overactivity.Renal denervation is a new,catheter based procedure to reduce renal and systemic sympathetic overactivity by disruption of renal sympathetic efferent and afferent nerves through radiofrequency or ultrasound energy delivered to the endoluminal surface of both renal arteries.Although several studies have shown the efficacy and safety of renal denervation in the treatment of resistant hypertension and the potential benefit of the procedure in other diseases,Symplicity HTN 3 study,the most rigorous clinical trial of renal denervation to date,failed to meet its primary endpoint.The procedure also has other limitations such as the lack of long term,efficacy and safety data and the lack of the predictors for the blood pressure lowering response and nonresponse to the procedure.An overview of current renal denervation devices holding Conformité Européenne mark is also included in this review.Conclusions Renal denervation is a promising therapeutic approach in the management of resistant hypertension and other diseases characterized by sympathetic overactivity.In its early stage of clinical application,the efficacy of the procedure is still controversial.Large scale,blind,randomized,controlled clinical trials are still necessary to address the limitations of the procedure.

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作者单位 Cardiovascular Division, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China ;Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia [1] Cardiovascular Division, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong 510280, China [2]
栏目名称 REVIEW ARTICLES
DOI 10.3760/cma.j.issn.0366-6999.20140267
发布时间 2014-10-09
基金项目
This study was supported by a grant from Guangdong Natural Science Foundation
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中华医学杂志(英文版)

中华医学杂志(英文版)

2014年127卷18期

3302-3308页

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