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Controversies surrounding renal denervation: real-world experience in two United Kingdom centers


Renal denervation ( RDN ) is a therapy that targets treatment-resistant hypertension ( TRH ).

The Symplicity HTN-1 and Symplicity HTN-2 trials reported response rates of more than 80%; however, sham-controlled Symplicity HTN-3 failed to reach its primary blood pressure outcome.

Researchers have presented real-world data from two Centers in the United Kingdom.

In this cohort, 52% of patients responded to renal denervation, with a 13±32 mm Hg reduction in office systolic blood pressure ( SBP ) at 6 months ( n=29, P=0.03 ).

Baseline office systolic blood pressure and number of ablations correlated with office SBP reduction ( R=-0.47, P=0.01; R=-0.56, P=o.002 ).

Renal denervation appears to be an effective treatment for some patients with treatment resistant hypertension ( TRH ); however, individual responses are highly variable.

Selecting patients for renal denervation is challenging, with only 10% ( 33 of 321 ) of the screened patients eligible for the study.

Medication alterations and nonadherence confound outcomes.

Adequate ablation is critical and should impact future catheter design/training.

Markers of procedural success and improved patient selection parameters remain key research aims. ( Xagena )

Burchell AE et al, J Clin Hypertens 2016; Epub ahead of print

XagenaMedicine_2016



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