Indications for renal denervation in the treatment of hypertension.

IF 4.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Hypertension Research Pub Date : 2024-08-07 DOI:10.1038/s41440-024-01823-3
Kenichi Katsurada, Kazuomi Kario
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Abstract

Renal denervation (RDN) is a neuromodulation therapy performed using an intraarterial catheter in patients with hypertension. Recent randomized sham-operated controlled trials have shown that RDN has significant antihypertensive effects in patients with resistant, uncontrolled, and/or drug-naïve hypertension. Based on available evidence, the European Society of Hypertension 2023 guidelines include a Class II recommendation for the use of RDN in individuals with resistant and uncontrolled hypertension. The US Food and Drug Administration approved two devices, the ultrasound-based ReCor ParadiseTM RDN system and the radiofrequency-based Medtronic Symplicity SpyralTM RDN system, as adjunctive therapy for patients with resistant and uncontrolled hypertension. The indications for RDN and incorporation of RDN into clinical practice will grow as clinical evidence accumulates. This mini review summarizes latest findings focusing on the safety and effectiveness of RDN for treating hypertension in the absence and presence of antihypertensive drugs, and discusses the indications for RDN. This mini review focuses on the safety and effectiveness of RDN for treating hypertension in the absence and presence of antihypertensive drugs. The indications for RDN and incorporation of RDN into clinical practice will grow as clinical evidence accumulates and should be reviewed and updated.

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治疗高血压的肾脏神经支配适应症。
肾脏去神经支配(RDN)是一种使用动脉内导管对高血压患者进行的神经调节疗法。最近的随机假手术对照试验表明,RDN 对耐药、未受控和/或药物无效的高血压患者具有显著的降压效果。根据现有证据,欧洲高血压学会 2023 年指南将 RDN 用于耐药和未控制的高血压患者列为二级推荐。美国食品和药物管理局批准了两种设备,即基于超声的 ReCor ParadiseTM RDN 系统和基于射频的美敦力 Symplicity SpyralTM RDN 系统,作为耐药和未控制高血压患者的辅助疗法。随着临床证据的不断积累,RDN 的适应症和将 RDN 纳入临床实践的情况会越来越多。本微综述总结了最新研究成果,重点介绍了在无降压药或有降压药的情况下,RDN 治疗高血压的安全性和有效性,并讨论了 RDN 的适应症。这篇微型综述的重点是在没有或有降压药物的情况下,RDN 治疗高血压的安全性和有效性。随着临床证据的不断积累,RDN 的适应症和将 RDN 纳入临床实践的情况将不断增加,因此应不断对其进行审查和更新。
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来源期刊
Hypertension Research
Hypertension Research 医学-外周血管病
CiteScore
7.40
自引率
16.70%
发文量
249
审稿时长
3-8 weeks
期刊介绍: Hypertension Research is the official publication of the Japanese Society of Hypertension. The journal publishes papers reporting original clinical and experimental research that contribute to the advancement of knowledge in the field of hypertension and related cardiovascular diseases. The journal publishes Review Articles, Articles, Correspondence and Comments.
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