Treating Hypertension Using Renal Artery Denervation: Problems and Progress

  • Raymond R. Townsend
    Address correspondence to Raymond R. Townsend, MD, Renal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania , 122 Founders Bldg, 3400 Spruce St, Philadelphia, PA 19104.
    Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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      Early reports of renal denervation as a therapy for hypertension generated intense interest in this approach to management of elevated blood pressures despite ongoing treatment. The publication of the large, sham-controlled randomized clinical trial of renal denervation, Symplicity HTN-3, failed to show superiority of renal denervation by radiofrequency energy ablation compared with a sham procedure similar to the procedure used for denervation but without the application of energy to the renal artery. This prompted consideration of confounding factors and rethinking about the protocol and the procedure itself. This review describes these confounders and the progress made to improve trial design in the field of renal artery denervation.

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