The current state of renal sympathetic denervation in hypertension

Jaime A. Gómez-Rosero, Departamento de Cardiología, Facultad de Medicina, Universidad CES, Medellín, Colombia
Laura Duque-González, Departamento de Cardiología, Facultad de Medicina, Universidad CES, Medellín; Departamento de Cardiología, Hospital San Vicente Fundación Rionegro, Rionegro; Colombia
Juan M. Senior-Sánchez, Departamento de Cardiología, Servicio de Hemodinamia y Cardiología Intervencionista, Hospital San Vicente Fundación Rionegro; Departamento de Cardiología, Universidad de Antioquia, Medellín. Colombia

This review provides an overview of the efficacy and safety of renal sympathetic denervation as a therapeutic approach for resistant hypertension. While the initial enthusiasm was sparked by the results of early clinical trials, it was dampened by the findings of the Symplicity HTN-3 study. However, recent advances in catheter technology and more refined patient selection criteria have yielded more promising results. Subsequent studies, such as SPYRAL HTN-OFF MED and RADIANCE II, demonstrated significant reductions in blood pressure, even in patients with mild to moderate hypertension. Despite the lack of robust data on major clinical outcomes, investigations into the time in therapeutic range for patients undergoing renal sympathetic denervation suggested potential cardiovascular benefits. Nevertheless, further research is needed to thoroughly understand the long-term impact, assess cost-effectiveness, and accurately identify which patient subgroups may derive the greatest benefits from this therapy.

Keywords: Resistant hypertension. Renal sympathetic denervation. Non-pharmacological treatment. Arterial hypertension. Time in therapeutic range. Cardiovascular outcomes.