IMR Press / RCM / Volume 20 / Issue 1 / DOI: 10.31083/j.rcm.2019.01.51
Open Access Review
Renal nerve ablation for resistant hypertension: facts, fictions and future directions
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1 CNR Institute of Clinical Physiology, c/o EUROLINE, Via Vallone Petrara 55-57, 89124 Reggio Calabria, Italy
2 Renal Unit, Department of Health Sciences, "Magna Graecia" University, 88100 Catanzaro, Italy
Rev. Cardiovasc. Med. 2019, 20(1), 9–18; https://doi.org/10.31083/j.rcm.2019.01.51
Published: 30 March 2019
Abstract

Hypertension remains a major public health problem and one of the most relevant causes of cardiovascular mortality and morbidity worldwide. Roughly 10% of hypertensive individuals are considered as “resistant” as they are not able to achieve and maintain optimal blood pressure values despite the concurrent use of 3 antihypertensive agents of different classes at optimal doses. As resistant hypertension conveys a higher risk of adverse outcomes, the search for effective treatments to properly manage this condition has progressively surged as a true health priority. The renal nerve plexus plays a central role in regulating arterial blood pressure and renal sympathetic overactivity is a major component in the development and progression of hypertension. On these premises, minimally-invasive catheter based devices for renal nerve ablation have been developed and tested as an alternative treatment for resistant hypertension, but clinical study results have been ambiguous. This review provides a historical perspective on the scientific evidence forming the foundation of renal never ablation from accrued clinical evidence to possible future applications, reaching a tentative conclusion that more research and clinical experience is needed to fully reveal limits and potential indications of this procedure.

Keywords
Resistant hypertension
renal denervation
renal nerve ablation
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