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Dasgupta, Indranil and Sharp, Andrew S P (2019) Renal sympathetic denervation for treatment of hypertension: where are we now in 2019? Current opinion in nephrology and hypertension. ISSN 1473-6543.
Full text not available from this repository.Abstract
PURPOSE OF REVIEW
Although sound physiological principles and surgical precedent underpin renal denervation as a therapy for treatment resistant hypertension, and early clinical studies had produced encouraging results, the first sham-controlled study (SYMPLICITY HTN-3) failed to achieve its primary efficacy endpoint. Lessons learnt from this trial, and the knowledge derived from further animal and autopsy work, have been applied in three recently published sham-controlled trials.
RECENT FINDINGS
These trials - SPYRAL OFF-MED, RADIANCE SOLO and SPYRAL ON-MED - using newer technologies, demonstrate a 5-10 mmHg incremental reduction in ambulatory SBP from RDN against sham-control, in patients with mild-to-moderate hypertension taking 0-3 drugs.
SUMMARY
These results provide proof of principle of the blood pressure-lowering effect of renal denervation. We now require data on long-term safety and durability of the procedure. Research is needed to identify predictive markers of response as about one-third of subjects do not respond to renal denervation. Hard-outcome data would be welcome but might be difficult to acquire. Individuals with treatment resistance are obvious treatment candidates, but RDN may also potentially benefit those with medication nonadherence and/or intolerance and those unwilling to take pills.
| Item Type: | Article |
|---|---|
| Subjects: | WG Cardiovascular system. Cardiology WJ Urogenital system. Urology |
| Divisions: | Emergency Services > Renal |
| Related URLs: | |
| Depositing User: | Mrs Yolande Brookes |
| Date Deposited: | 05 Jul 2019 12:46 |
| Last Modified: | 05 Jul 2019 12:46 |
| URI: | http://www.repository.uhblibrary.co.uk/id/eprint/2206 |
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