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Efficacy Evidence
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Pre-clinical Evidence
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Hypertension Management

Renal Denervation Provides a Complementary Treatment Option

 

Click Here to Download the ESH Guidelines RDN Summary Click Here to Download the ESC Guidelines RDN Summary

 

There are currently 1.28 million adults with hypertension globally.1 Uncontrolled hypertension affects approximately 10% to 30% of these individuals and is associated with an increased risk of cardiovascular events, such as stroke, myocardial infarction, heart failure, and cardiovascular mortality.2 In Europe, hypertension (HTN) is defined as in-office systolic blood pressure (SBP) values ≥140 mmHg and/or diastolic blood pressure (DBP) values ≥90 mmHg. The goal of managing HTN in Europe is to lower office SBP to <140/90 mmHg, and, if treatment is well tolerated, to <130/80 mmHg. Even small reductions in blood pressure can lead to significant risk reduction. Each 10mmHg reduction in office SBP provides a 20% reduction in relative risk of major adverse cardiovascular events (MACE) and a 27% reduction in risk of stroke.3 

Lowering BP through the use of antiHTN drugs has been shown to reduce the risk for CV morbidity and all-cause mortality, however, BP control rates remain poor worldwide. Renal denervation is a minimally invasive procedure that targets the nerves surrounding the renal artery. Radiofrequency (RF) renal denervation provides controlled and targeted energy which safely disrupts the overactive sympathetic signalling between the kidneys and the brain to reduce blood pressure.4 

Several clinical trials have evaluated the safety and efficacy of radiofrequency renal denervation for the treatment of uncontrolled hypertension reporting safe and clinically meaningful blood pressure reduction.5,6,7 RF renal denervation has demonstrated sustained BP reductions out to 3 years in over 2,000 patients and out to 9 years in independent research.  

Consensus documents from the European Society of Hypertension and a joint statement from the ESC Council on Hypertension and European Association of Percutaneous Cardiovascular Intervention (EAPCI) support RDN as an evidence-based treatment option for uncontrolled hypertensive patients.

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Prof Flavio Ribichini

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Durability Evidence

Catheter‐based renal denervation for resistant arterial hypertension: 10‐year real‐world follow‐up data

Brouwers S, Botti G, Verbesselt M, et al. J Clin Hypertens (Greenwich) 2024;26:1521–7.

Effects of renal denervation on the incidence and severity of cardiovascular diseases

Katsurada K, Kario K. Hypertens Res 2024;47:2700–10.

Long-term blood pressure reductions following catheter-based renal denervation: a systematic review and meta-analysis

Sesa-Ashton G, Nolde JM, Muente I, et al. Hypertension 2024;81:e63–70.

[Five-year dynamics adrenergic reactivity of erythrocytes after radio-frequency sympathic denervation of renal arteries in patients with resistant arterial hypertension]

Rebrova TY, Falkovskaya AY, Afanasiev SA, et al. Ter Arkh 2023;95:757–62.

Blood pressure control and clinical outcomes after renal denervation through irrigated catheter radiofrequency ablation in patients with resistant hypertension: a case series with up to 10 years of follow-up

do Carmo LV, Pereira KD, Goulart MA, et al. High Blood Press Cardiovasc Prev 2024;31:687–94.

A novel, proof-of-concept radiofrequency renal denervation strategy to improve procedural efficiency: 12-month results from the SPYRAL DYSTAL pilot study

Sharp ASP, Kandzari DE, Townsend RR, et al. Cardiovasc Revasc Med 2024;68:30–6.

Long-term efficacy and safety of renal denervation: an update from registries and randomised trials

Dimitriadis K, Schmieder RE, Iliakis P, et al. Blood Press 2023;32:2266664.

Skin sodium content as a predictor of blood pressure response to renal denervation

Guenes-Altan M, Schmid A, Kannenkeril D, et al. Hypertens Res 2024;47:361–71.

36-month durability of ultrasound renal denervation for hypertension resistant to combination therapy in RADIANCE-HTN TRIO

Bloch MJ, Kirtane AJ, Azizi M, et al. Hypertens Res 2024;47:3467–72.

Long-term safety and efficacy of renal sympathetic denervation in atrial fibrillation: 3-year results of the AFFORD study

Zeijen VJM, Theuns DA, Feyz L, et al. Clin Res Cardiol 2023;112:1766–77.

Ultra-long-term efficacy and safety of catheter-based renal denervation in resistant hypertension: 10-year follow-up outcomes

Al Ghorani H, Kulenthiran S, Lauder L, et al. Clin Res Cardiol 2024;113:1384–92.

Safety and efficacy of renal sympathetic denervation: a 9-year long-term follow-up of 24-hour ambulatory blood pressure measurements

Vogt A, Dutzmann J, Nußbaum M, et al. Front Cardiovasc Med 2023;10:1210801.

Clinical event reductions in high-risk patients after renal denervation projected from the global SYMPLICITY registry

Schmieder RE, Mahfoud F, Mancia G, et al. Eur Heart J Qual Care Clin Outcomes 2023;9:575–82.

Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial

Mahfoud F, Kandzari DE, Kario K, et al. Lancet 2022;399:1401–10.

Long-term reduction in morning and nighttime blood pressure after renal denervation: 36-month results from SPYRAL HTN-ON MED trial

Kario K, Mahfoud F, Kandzari DE, et al. Hypertens Res 2023;46:280–8.

Long-term outcomes after catheter-based renal artery denervation for resistant hypertension: final follow-up of the randomised SYMPLICITY HTN-3 trial

Bhatt DL, Vaduganathan M, Kandzari DE, et al. Lancet 2022;400:1405–16.

Catheter-based renal denervation: 9-year follow-up data on safety and blood pressure reduction in patients with resistant hypertension

Sesa-Ashton G, Nolde JM, Muente I, et al. Hypertension 2023;80:811–9.

10-year outcomes of catheter-based renal denervation in patients with resistant hypertension

Al Ghorani H, Kulenthiran S, Recktenwald MJM, et al. J Am Coll Cardiol 2023;81:517–9.

Long-term follow-up of patients undergoing renal sympathetic denervation

Zeijen VJM, Feyz L, Panday RN, et al. Clin Res Cardiol 2022;111:1256–68.

Quality of life following renal sympathetic denervation in treatment-resistant hypertensive patients: a two-year follow-up study

Hanssen TA, Subbotina A, Miroslawska A, et al. Scand Cardiovasc J 2022;56:174–9.

Efficacy Evidence

Super-response to renal denervation in treatment-resistant essential hypertension

Safdar NZ, Shah MU, Ali A, Naqvi SY. BMJ Case Rep 2024;17:e260945.

Anti-hypertensive medication adherence in the REQUIRE trial: post-hoc exploratory evaluation

Kario K, Kai H, Nanto S, Yokoi H. Hypertens Res 2023;46:2044–7.

Progression of obstructive sleep apnoea after renal denervation is not associated with hypertension exaggeration

Korostovtseva LS, Ionov MV, Shcherbakova EA et al. BMC Pulm Med 2023;23:467.

Alcohol-mediated renal denervation in patients with hypertension in the absence of antihypertensive medications

Pathak A, Rudolph UM, Saxena M, et al. EuroIntervention 2023;19:602–11.

Overview of the 2023 FDA Circulatory System Devices Advisory Panel Meeting on the Symplicity Spyral Renal Denervation System

Chitturi KR, Haberman D, Wermers JP, Waksman R. Am Heart J 2024;269:108–17.

Radiofrequency catheter ablation for pulmonary hypertension patients with atrial flutter

Zhang A, Ding L, Zhang H, et al. ESC Heart Fail 2024;11:883–92.

Real-world experience with ultrasound renal denervation utilizing home blood pressure monitoring: the Global Paradise System registry study design

Mahfoud F, Azizi M, Daemen J, et al. Clin Res Cardiol 2024;113:1375–83.

Salt sensitivity risk derived from nocturnal dipping and 24-h heart rate predicts long-term blood pressure reduction following renal denervation

Sesa-Ashton G, Carnagarin R, Nolde JM, et al. J Hypertens 2024;42:922–7.

Ten-year follow-up of very-high risk hypertensive patients undergoing renal sympathetic denervation

Wang L, Li C, Li Z, et al. J Hypertens 2024;42:801–8.

Impact of renal denervation on urinary peptide-based biomarkers in hypertension

Lauder L, Siwy J, Mavrogeorgis E, et al. Hypertension 2024;81:1374–82.

Outcomes following radiofrequency renal denervation according to antihypertensive medications: subgroup analysis of the Global SYMPLICITY Registry DEFINE

Mahfoud F, Mancia G, Schmieder RE, et al. Hypertension 2023;80:1759–70.

Impact of antihypertensive medication changes after renal denervation among different patient groups: SPYRAL HTN-ON MED

Townsend RR, Ferdinand KC, Kandzari DE, et al. Hypertension 2024;81:1095–105.

Modulation of pulsatile left ventricular afterload by renal denervation in heart failure with preserved ejection fraction

Rommel KP, Pagoulatou S, Kresoja KP, et al. Circ Heart Fail 2023;16:e010543.

A novel, proof-of-concept radiofrequency renal denervation strategy to improve procedural efficiency: 12-month results from the SPYRAL DYSTAL pilot study

Sharp ASP, Kandzari DE, Townsend RR, et al. Cardiovasc Revasc Med 2024; epub ahead of press.

Anti-hypertensive medication adherence in the REQUIRE trial: post-hoc exploratory evaluation

Kario K, Kai H, Nanto S, Yokoi H. Hypertens Res 2023;46:2044–7.

Blood pressure reduction after renal denervation in patients with or without chronic kidney disease

Günes-Altan M, Schmid A, Ott C, et al. Clin Kidney J 2023;17:sfad237.

Cost-effectiveness of catheter-based radiofrequency renal denervation for the treatment of uncontrolled hypertension: an analysis for the UK based on recent clinical evidence

Sharp ASP, Cao KN, Esler MD, et al. Eur Heart J Qual Care Clin Outcomes 2024; epub ahead of press.

Safety and efficacy of renal denervation in patients taking antihypertensive medications

Kandzari DE, Townsend RR, Kario K, et al. J Am Coll Cardiol 2023;82:1809–23.

Radiofrequency-based renal denervation: a story of simplicity?

Götzinger F, Kunz M, Lauder L, et al. Future Cardiol 2023; epub ahead of press.

Relationship between clinic and ambulatory blood pressure and mortality: an observational cohort study in 59 124 patients

Staplin N, de la Sierra A, Ruilope LM, et al. Lancet 2023;401:2041–50.

Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial

Böhm M, Kario K, Kandzari DE, et al. Lancet 2020;395:1444–51.

Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomised trial

Kandzari DE, Böhm M, Mahfoud F, et al. Lancet 2018;391:2346–55.

Renal denervation in high-risk patients with hypertension

Mahfoud F, Mancia G, Schmieder R, et al. J Am Coll Cardiol 2020;75:2879–88.

Patient preferences for pharmaceutical and device-based treatments for uncontrolled hypertension: discrete choice experiment

Kandzari DE, Weber MA, Poulos C, et al. Circ Cardiovasc Qual Outcomes 2023;16:e008997.

Cardiovascular risk reduction after renal denervation according to time in therapeutic systolic blood pressure range

Mahfoud F, Mancia G, Schmieder RE, et al. J Am Coll Cardiol 2022;80:1871–80.

Clinical event reductions in high-risk patients after renal denervation projected from the Global SYMPLICITY Registry

Schmieder RE, Mahfoud F, Mancia G, et al. Eur Heart J Qual Care Clin Outcomes 2022; epub ahead of press.

Guidelines

2024 ESC Guidelines for the management of elevated blood pressure and hypertension

McEvoy JW, McCarthy CP, Maria Bruno R, et al. Eur Heart J 2024;45:3912–4018.

2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension 

Mancia G, Kreutz R, Brunström M, et al. J Hypertens 2023; epub ahead of press.

Renal Denervation in the treatment of resistant hypertension and difficult-to-control hypertension

Jelaković B, Perkov D, Barišić K, et al. Vasc Health Risk Manag 2023;19:805–26.

[Italian Society of Interventional Cardiology (GISE) and Italian Society of Arterial Hypertension (SIIA) Consensus document on the role of renal denervation in the management of the difficult to treat hypertension]

Stabile E, Muiesan ML, Ribichini FL, et al. G Ital Cardiol (Rome) 2023;24:53S–63S.

Consensus statement on renal denervation by the Joint Committee of Japanese Society of Hypertension (JSH), Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT), and the Japanese Circulation Society (JCS)

Kario K, Kai H, Rakugi H, et al. Cardiovasc Interv Ther 2024;39:376–85.

Highlights from the New European Society of Hypertension Guidelines Document

Grassi G. Curr Hypertens Rev 2024;20:66–9.

Treatment of primary aldosteronism: clinical practice guidelines of the Taiwan Society of Aldosteronism

Tseng CS, Chan CK, Lee HY, et al. J Formos Med Assoc 2024;123:S125–34.

Management of nocturnal hypertension: an expert consensus document from Chinese Hypertension League

Liu J, Li Y, Zhang X, et al. J Clin Hypertens (Greenwich) 2024;26:71–83.

Italian Society of Interventional Cardiology (GISE) and Italian Society of Arterial Hypertension (SIIA) Position Paper on the role of renal denervation in the management of the difficult-to-treat hypertension

Stabile E, Muiesan ML, Ribichini FL, et al. Minerva Cardiol Angiol 2024;72:313–28.

Overview of the 2023 FDA Circulatory System Devices Advisory Panel meeting on the Recor Paradise Ultrasound-Based Renal Denervation System

Haberman D, Chitturi KR, Lupu L, et al. Catheter Cardiovasc Interv 2024;104:34–43.

Renal sympathetic denervation 2024 in Austria: recommendations from the Austrian Society of Hypertension : Endorsed by the Austrian Society of Nephrology and the Working Group of Interventional Cardiology of the Austrian Society of Cardiology

Zweiker D, Koppelstätter C, Hohenstein K, et al. Wien Klin Wochenschr 2024;136:559–69.

Catheter-based renal denervation in the treatment of arterial hypertension

Pathak A, Boulestreau R, Sapoval M, et al. Arch Cardiovasc Dis 2024;117:601–11.

Resistant hypertension: diagnosis, evaluation, and treatment a clinical consensus statement from the Thai hypertension society

Chattranukulchai P, Roubsanthisuk W, Kunanon S, et al. Hypertens Res 2024;47:2447–55.

Consensus statement on renal denervation by the Joint Committee of Japanese Society of Hypertension (JSH), Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT), and the Japanese Circulation Society (JCS)

Kario K, Kai H, Rakugi H, et al. Hypertens Res 2024;47:2624–32.

Consensus statement on renal denervation by the Joint Committee of Japanese Society of Hypertension (JSH), Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT), and the Japanese Circulation Society (JCS)

Kario K, Kai H, Rakugi H, et al. Circ J 2024;88:1718–25.

Renal denervation for the treatment of hypertension: a scientific statement from the American Heart Association

Cluett JL, Blazek O, Brown AL, et al. Hypertension 2024;81:e135–48.

Consensus document of the Italian Society of Interventional Cardiology (GISE) and the Italian Society of Arterial Hypertension (SIIA) on the role of renal denervation in the management of difficult-to-treat arterial hypertension

Stabile E, Muiesan ML, Ribichini FL, et al. G Ital Cardiol (Rome) 2023;24:53–63.

Renal denervation in hypertension patients: proceedings from an expert consensus roundtable cosponsored by SCAI and NKF

Kandzari DE, Townsend RR, Bakris G, et al. Catheter Cardiovasc Interv 2021;98:416–26.

European Society of Hypertension position paper on renal denervation 2021

Schmieder RE, Mahfoud F, Mancia G, et al. J Hypertens 2021;39:1733–41.

Clinical trial design principles and outcomes definitions for device-based therapies for hypertension: a consensus document from the hypertension academic research consortium

Kandzari DE, Mahfoud F, Weber MA, et al. Circulation 2022;145:847–63.

Renal denervation in the management of hypertension in adults. A clinical consensus statement of the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Barbato E, Azizi M, Schmieder RE, et al. Eur Heart J 2023;44:1313–30.

Pre-clinical Evidence

Afferent renal denervation attenuates sympathetic overactivation from the paraventricular nucleus in spontaneously hypertensive rats

Li KH, Lin JM, Luo SQ, et al. Am J Hypertens 2024;37:477–84.

Sequential afferent and sympathetic renal denervation impact on cardiovascular and renal homeostasis in the male Sprague-Dawley rat

Parvin I, Gauthier MM, Dennis MR, et al. Life Sci 2023;325:121768.

Hypertension-induced heart failure disrupts cardiac sympathetic innervation

Scalco A, Lee EN, Johnson MA, et al. Am J Physiol Heart Circ Physiol 2024;327:H1544–58.

Renal denervation restores biomechanics of carotid arteries in a rat model of hypertension

Gkousioudi A, Razzoli M, Moreira JD, et al. Sci Rep 2024;14:495.

The total denervation of the ischemic kidney induces differential responses in sodium transporters' expression in the contralateral kidney in Goldblatt rats

Shimoura CG, Oliveira TL, Lincevicius GS, et al. Int J Mol Sci 2024;25:6962.

TRPV1 signaling of perirenal adipose tissue promotes DOCA-Salt-induced hypertension and kidney injury

Hua D, Huang W, Huang W, et al. J Hypertens 2024;42:1409–20.

Renal denervation improves mitochondrial oxidative stress and cardiac hypertrophy through inactivating SP1/BACH1-PACS2 signaling

Shen Z, Zhang Y, Bu G, Fang L. Int Immunopharmacol 2024;141:112778.

Forgotten circulation: reduced mesenteric venous capacitance in hypertensive rats is improved by decreasing sympathetic activity

Emans TW, Moraes DJA, Ben-Tal A, et al. Hypertension 2024;81:823–35.

Histological examination of renal nerve distribution, density, and function in humans

Struthoff H, Lauder L, Hohl M, et al. EuroIntervention 2023;19:612–20.

Time, temperature, power, and impedance considerations for radiofrequency catheter renal denervation

Coates P, Tunev S, Trudel J, Hettrick DA. Cardiovasc Revasc Med 2022;42:171–7.

Histological evidence supporting the durability of successful radiofrequency renal denervation in a normotensive porcine model

Sharp ASP, Tunev S, Schlaich M, et al. J Hypertens 2022;40:2068–75.

Comprehensive assessment of human accessory renal artery periarterial renal sympathetic nerve distribution

Sato Y, Kawakami R, Jinnouchi H, et al. JACC Cardiovasc Interv 2021;14:304–15.

Review Articles

Patient-specific factors predicting renal denervation response in patients with hypertension: a systematic review and meta-analysis

Hu XR, Liao GZ, Wang JW, et al. J Am Heart Assoc 2024;13:e034915.

Randomized trials of renal denervation for uncontrolled hypertension: an updated meta-analysis

Mufarrih SH, Qureshi NQ, Khan MS, et al. J Am Heart Assoc 2024;13:e034910.

Multiple drug intolerance in antihypertensive patients: what is known and what is missing

Palermiti A, Pappaccogli M, Rabbia F, et al. J Hypertens 2024;42:1289–97.

Renal denervation for uncontrolled hypertension: a systematic review and meta-analysis examining multiple subgroups

Sharp ASP, Sanderson A, Hansell N, et al. J Hypertens 2024;42:1133–44.

Renal artery denervation for the management of hypertension: current trends and future direction

Naqvi SY, Shah MU, Renner M, et al. Am J Med 2024;137:1190–9.e4.

Controversies in hypertension IV: renal denervation

Filippone EJ, Naccarelli GV, Foy AJ. Am J Med 2023;136:857–68.

Opportunities and limitations of renal denervation: where do we stand?

Castillo Rodriguez B, Secemsky EA, Swaminathan RV, et al. Am J Med 2024;137:712–8.

Controversies in hypertension V: resistant and refractory hypertension

Filippone EJ, Naccarelli GV, Foy AJ. Am J Med 2024;137:12–22.

Autonomic nervous system: a therapeutic target for cardiac end-organ damage in hypertension

Gottlieb LA, Mahfoud F, Stavrakis S, et al. Hypertension 2024;81:2027–37.

Sympathetic pathophysiology in hypertension origins: the path to renal denervation

Esler MD, Osborn JW, Schlaich MP. Hypertension 2024;81:1194–205.

Salt-sensitive hypertension and the kidney

Nishimoto M, Griffin KA, Wynne BM, Fujita T. Hypertension 2024;81:1206–17.

Taming resistant hypertension: the promise of novel pharmacologic approaches and renal denervation

Azzam O, Nejad SH, Carnagarin R, et al. Br J Pharmacol 2024;181:319–39.

Efficacy of pharmacological and interventional treatment for resistant hypertension: a network meta-analysis

Tian Z, Barbosa CV, Lang H, et al. Cardiovasc Res 2024;120:108–19.

Evaluation and management of resistant hypertension: core curriculum 2024

Cluett JL, William JH. Am J Kidney Dis 2024;84:374–87.

Does the kidney influence the hunger for salt?

Bailey MA. Kidney Int 2024;106:1025–8.

Effects of catheter-based renal denervation in hypertension: a systematic review and meta-analysis

Vukadinović D, Lauder L, Kandzari DE, et al. Circulation 2024;150:1599–611.

Management of resistant hypertension

Lauder L, Mahfoud F, Böhm M. Annu Rev Med 2024;75:443–57.

Hypertension management in patients with cardiovascular comorbidities

Lauder L, Mahfoud F, Azizi M, et al. Eur Heart J 2023;44:2066–77.

Diagnosis and management of resistant hypertension

Schiffrin EL, Fisher NDL. BMJ 2024;385:e079108.

Overview of the evolution of hypertension: from ancient Chinese emperors to today

Bakris GL, Weber MA. Hypertension 2024;81:717–26.

Renal denervation in the management of hypertension

Lauder L, Kandzari DE, Lüscher TF, Mahfoud F. EuroIntervention 2024;20:e467–78.

Management of resistant hypertension

Lauder L, Mahfoud F, Böhm M. Annu Rev Med 2023; epub ahead of press.

Taming resistant hypertension – the promise of novel pharmacologic approaches and renal denervation

Azzam O, Nejad SH, Carnagarin R, et al. Br J Pharmacol 2023; epub ahead of press.

Renal denervation as a complementary treatment option for uncontrolled arterial hypertension: a situation assessment

Wagener M, Dolan E, Arnous S, et al. J Clin Med 2023;12:5634.

Hypertension management in patients with cardiovascular comorbidities

Lauder L, Mahfoud F, Azizi M, et al. Eur Heart J 2022; epub ahead of press.

Renal denervation: a review

Rey-García J, Townsend RR. Am J Kidney Dis 2022;80:527–35.

Renal denervation: a practical guide for health professionals managing hypertension

Schmieder R, Burnier M, East C, et al. Interventional Cardiology 2023;18:e06.

Medication adherence in hypertension: lessons learned from renal denervation trials

Fisher NDL, Mahfoud F. Eur J Prev Cardiol 2023;30:34–6.

Renal denervation in the antihypertensive arsenal – knowns and known unknowns

Messerli FH, Bavishi C, Brguljan J, et al. J Hypertens 2022;40:1859–75.

Novel therapies on the horizon of hypertension management

Blazek O, Bakris GL. Am J Hypertens 2023;36:73–81.

Renal denervation for atrial fibrillation: a comprehensive updated systematic review and meta-analysis

Nawar K, Mohammad A, Johns EJ, Abdulla MH. J Hum Hypertens 2022;36:887–97.

Renal denervation for resistant hypertension: a concise update on treatment options and the latest clinical evidence

Fengler K. Cardiol Ther 2022;11:385–92.

Update on renal sympathetic denervation for the treatment of hypertension

Rao A, Krishnan N. Curr Cardiol Rep 2022;24:1261–71.

The role of blood pressure management in stroke prevention: current status and future prospects

Narita K, Hoshide S, Kario K. Expert Rev Cardiovasc Ther 2022;20:829–38.

Newer alternatives for resistant hypertension: beyond 2022 paradigms

Laffin LJ, Briasoulis A, Bakris GL. Hellenic J Cardiol 2023;70:75–7.

The impact of renal denervation procedure on use of antihypertensive drugs in the real-life setting

Rea F, Morabito G, Savaré L, et al. Blood Press 2022;31:245–53.

Safety Evidence

Impact of renal denervation on patients with coronary microvascular dysfunction: study rationale and design

Migliaro S, Petrolini A, Mariani S, Tomai F. J Cardiovasc Med (Hagerstown) 2024;25:379–85.

CT-guided ozone-mediated lumbar-renal sympathetic denervation for resistant hypertension treatment: a pilot single-arm clinical trial

Li L, Liu J, Huang B, et al. Cardiovasc Revasc Med 2024;67:51–7.

CT-guided ozone-mediated lumbar-renal sympathetic denervation for resistant hypertension treatment: a pilot single-arm clinical trial

Li L, Liu J, Huang B, et al. Cardiovasc Revasc Med 2024;67:51–7.

Laser renal denervation: a comprehensive evaluation of microstructural renal artery lesions

Vakhrushev AD, Leandro HIC, Goncharova NS, et al. Anat Rec (Hoboken) 2023;306:2378–87.

The feasibility, efficacy, and safety of RDN procedure using CO(2) angiography through radial artery in severe chronic kidney disease patients

Lo HY, Lee JK, Lin YH. Hypertens Res 2024;47:760–6.

Feasibility and safety of same-day discharge following radiofrequency renal artery sympathetic denervation

Fezzi S, Gibson W, Wagener M, et al. J Am Heart Assoc 2023;12:e030742.

Safety and efficacy of renal denervation in patients taking antihypertensive medications

Kandzari DE, Townsend RR, Kario K, et al. J Am Coll Cardiol 2023;82:1809–23.

Effects of renal denervation on kidney function in patients with chronic kidney disease: a systematic review and meta-analysis

Mohammad AA, Nawar K, Binks O, Abdulla MH. J Hum Hypertens 2024;38:29–44.

Long-term safety and antihypertensive effects of renal denervation: current insights

Reyes KR, Rader F. Integr Blood Press Control 2023;16:59–70.

Feasibility and safety of same-day discharge following radiofrequency renal artery sympathetic denervation

Fezzi S, Gibson W, Wagener M, et al. J Am Heart Assoc 2023;12:e030742.

Review and meta-analysis of renal artery damage following percutaneous renal denervation with radiofrequency renal artery ablation

Townsend RR, Walton A, Hettrick DA, et al. EuroIntervention 2020;16:89–96.

Effects of renal denervation on kidney function and long-term outcomes: 3-year follow-up from the Global SYMPLICITY Registry

Mahfoud F, Böhm M, Schmieder R, et al. Eur Heart J 2019;40:3474–82.

Insights on safety and efficacy of renal artery denervation for uncontrolled-resistant hypertension in a high risk population with chronic kidney disease: first Italian real-world experience

Marin F, Fezzi S, Gambaro A, et al. J Nephrol 2021;34:1445–55.

Renal denervation in patients with versus without chronic kidney disease: results from the Global SYMPLICITY Registry with follow-up data of 3 years

Ott C, Mahfoud F, Mancia G, et al. Nephrol Dial Transplant 2022;37:304–10.

Hypertension urgencies in the SPYRAL HTN-OFF MED Pivotal trial

Weber MA, Schmieder RE, Kandzari DE, et al. Clin Res Cardiol 2022;111:1269–75.

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