
Hypertension Management
Renal Denervation Provides a Complementary Treatment Option
Download the ESH Guidelines RDN Summary
Download the ESC Guidelines RDN Summary
Current hypertension care strategies are not aIways enough to help patients achieve BP control. European hypertension guidelines now recommend renal denervation as a safe and effective additional treatment option.1,2
Over half of treated hypertension patients remain uncontrolled leading to an increased risk of cardiovascular events, but 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.3,4 Renal denervation is a minimally invasive procedure that is proven to achieve significant, safe and sustained blood pressure reductions.5-9
Section Advisor: Prof Flavio Ribichini

This resource hub is supported by
References
1. Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). J Hypertens 2023;41:1874–2071.
2. McEvoy JW, McCarthy CP, Bruno RM, et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO). European Heart Journal 2024;45:3912–4018.
3. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol 2020;16:223–37.
4. Ettehad D, Edmin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet 2016;387:957–67.
5. Böhm M, Kario K, Kandzari DE, et al. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. Lancet 2020;395:1444–51.
6. Kandzari D, Townsend R, Kario K, et al. Safety and efficacy of renal denervation in patients taking antihypertensive medication. J Am Coll Cardiol 2023;82:1809–23.
7. Mahfoud F, Kandzari DE, Kario K, et al. Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial. Lancet 2022;399:1401–10.
8. Mahfound F, Mancia G, Schmieder R, et al. Outcomes following radiofrequency renal denervation according to antihypertensive medications: subgroup analysis of the Global SYMPLICITY Registry DEFINE. Hypertension 2023;80:1759–70.
Recent Videos

Join Prof Atul Pathak (Clinique Pasteur, FR) and Prof Sofie Brouwers (Olv Hospital Aalst, BE) in this video on 'Renal Denervation Takeaways From ESC Guidelines'.

ESC Congress 2024 — Dr Rhian Touyz (McGill University Health Center, CA) joins us to discuss key highlights from the ESC 2024 guidelines for the management of elevated blood pressure and hypertension.

Join Prof Andrew Sharp in this video on 'Cost Effectiveness Analysis of Renal Denervation'.

Join Prof Flavio Ribichini (University of Verona, IT), an expert in the field of renal denervation (RDN), as he discusses the current state of RDN, along with new guidelines and recent updates in the field.

Join Prof Flavio Ribichini (University of Verona, IT), an expert in the field of renal denervation (RDN), as he reviews the top five advancements in hypertension management and RDN from the past year.

Join Prof Felix Mahfoud in this video on 'Long-Term Results of RF RDN'.

Join Dr Tai Kobayashi (Penn Heart and Vascular Center, US) as he gives an 'Introduction to The Symplicity Spyral Renal Denervation System'.

Join Dr David Kandzari in this video on 'Durability of RF Renal Denervation'.

Join Prof Felix Mahfoud in this video on 'Safety and Efficacy of Renal Denervation'.

Join Dr David Kandzari (Piedmont Heart Institute, US) in this video on Renal Denervation: The Totality of Evidence.

Prof Andrew Sharp and Dr Stefan Tunev discuss the Science of Renal Denervation Technology.

Prof Atul Pathak (Princess Grace Hospital, MC) will give an update on the ESH guidelines.

Join this session to explore the latest innovations in device-based treatment for hypertension.

In this on-demand version of the live broadcast, Radcliffe Medical Education brings together a globally-renowned European and American faculty to share best practices on resistant hypertension and renal denervation (RDN).

A discussion between Prof Felix Mahfoud & Dr Anastasia Mihailidou.

In this short late-breaking interview, Prof Felix Mahfoud (Saarland University Hospital, DE) discusses the 3-year efficacy outcomes of the SPYRAL HTN-ON MED Pilot Study (NCT02439775).
Guidelines

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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