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• W2045123721 abstract "Despite widespread use of conventional antihypertensive therapy, which effectively reduces blood pressure in most hypertensive patients, a failure to attain target blood pressure levels in about 10% of patients with arterial hypertension suggests a deficit in present strategies, leaving this patient cohort at high risk of cardiovascular and renal disease. 1 Mancia G Fagard R Narkiewicz K et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013; 31: 1281-1357 Crossref PubMed Scopus (3995) Google Scholar Although mechanisms underlying the pathogenesis of arterial hypertension are complex and multifactorial, augmented sympathetic activation crucially contributes to hypertension and its adverse effects. Moreover, high levels of muscle sympathetic nerve activity predominantly feature in patients with resistant hypertension despite multidrug treatment. 2 Hering D Lambert EA Marusic P et al. Substantial reduction in single sympathetic nerve firing after renal denervation in patients with resistant hypertension. Hypertension. 2013; 61: 457-464 Crossref PubMed Scopus (275) Google Scholar , 3 Hering D Marusic P Walton AS et al. Sustained sympathetic and blood pressure reduction 1 year after renal denervation in patients with resistant hypertension. Hypertension. 2014; 64: 118-124 Crossref PubMed Scopus (111) Google Scholar Renal denervation is a recent development in the management of drug-resistant hypertension that opposes sympathetic activity. Renal denervation has substantial clinical and pathophysiological relevance and a favourable safety profile, resulting in a sustained reduction in blood pressure and sympathetic nerve activity. 2 Hering D Lambert EA Marusic P et al. Substantial reduction in single sympathetic nerve firing after renal denervation in patients with resistant hypertension. Hypertension. 2013; 61: 457-464 Crossref PubMed Scopus (275) Google Scholar , 3 Hering D Marusic P Walton AS et al. Sustained sympathetic and blood pressure reduction 1 year after renal denervation in patients with resistant hypertension. Hypertension. 2014; 64: 118-124 Crossref PubMed Scopus (111) Google Scholar , 4 DiBona GF Esler M Translational medicine: the antihypertensive effect of renal denervation. Am J Physiol Regul Integr Comp Physiol. 2010; 298: R245-R253 Crossref PubMed Scopus (324) Google Scholar , 5 Krum H Schlaich M Whitbourn R et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet. 2009; 373: 1275-1281 Summary Full Text Full Text PDF PubMed Scopus (1763) Google Scholar , 6 Krum H Schlaich MP Sobotka PA et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. Lancet. 2014; 383: 622-629 Summary Full Text Full Text PDF PubMed Scopus (487) Google Scholar , 7 Esler MD Bohm M Sievert H et al. Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial. Eur Heart J. 2014; 35: 1752-1759 Crossref PubMed Scopus (197) Google Scholar Optimum and stepped care standardised antihypertensive treatment with or without renal denervation for resistant hypertension (DENERHTN): a multicentre, open-label, randomised controlled trialIn patients with well defined resistant hypertension, renal denervation plus an SSAHT decreases ambulatory blood pressure more than the same SSAHT alone at 6 months. This additional blood pressure lowering effect may contribute to a reduction in cardiovascular morbidity if maintained in the long term after renal denervation. Full-Text PDF" @default.
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• W2045123721 date "2015-05-01" @default.
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• W2045123721 title "Renal denervation superior to drug therapy in hypertension" @default.
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