Renal denervation for hypertension: where are we now?

Hypertension is a growing clinical burden associated with significant morbidity and mortality. Those patients who remain with uncontrolled blood pressure despite multiple appropriate tablets are labelled as resistant hypertension. This cohort faces the highest risk. A key driving factor in resistant hypertension is an abnormally elevated sympathetic nervous system (SNS). It is now possible to attenuate this non-pharmacologically by performing radiofrequency ablation to the renal sympathetic nerves using a transcatheter approach. Currently available trial data show impressive blood pressure reductions with this therapy and, more importantly, its relative safety. The National Health Service (NHS) experience with this procedure is at an early stage, but is likely to grow with guidance already published by the joint British Societies and National Institute for Health and Care Excellence (NICE).

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