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Renal denervation for human hypertension: is there a future?
- Source :
-
Journal of the American Society of Hypertension : JASH [J Am Soc Hypertens] 2016 May; Vol. 10 (5), pp. 390-2. Date of Electronic Publication: 2016 Mar 08. - Publication Year :
- 2016
-
Abstract
- The sympathetic nervous system plays a permissive, if not primary causal role in the genesis and maintenance of human essential hypertension. Excessive sympathetic nervous system activity in man is most apparent in early forms of hypertension (prehypertension and white-coat type). Renal nerves are of particular interest because of their roles in modulating the activity of the renin-angiotensin system and renal sodium excretion. Renal denervation substantially ameliorates the development of hypertension in animal models such as renovascular, spontaneously hypertensive, and steroid-induced hypertension in rats and aortic coarctation in dogs. In man, catheter ablation of renal nerves has been undertaken in the late phases of hypertension; in a rigorously controlled trial in resistant hypertension (SYMPLICITY HTN-3), renal denervation did not reduce blood pressure over the long term. Is this because renal denervation is more appropriate to prevent than treat late-stage hypertension? Are there anatomical or technical barriers yet to be overcome in the procedure? These and other issues are addressed by two experts in this issue of the controversies series: Deepak L. Bhatt and Murray Epstein.<br /> (Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Animals
Controlled Clinical Trials as Topic
Dogs
Essential Hypertension
Humans
Hypertension prevention & control
Rats
Renin-Angiotensin System
Blood Pressure physiology
Catheter Ablation
Coronary Vasospasm surgery
Hypertension surgery
Kidney innervation
Sympathectomy
Sympathetic Nervous System surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-7436
- Volume :
- 10
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of the American Society of Hypertension : JASH
- Publication Type :
- Academic Journal
- Accession number :
- 27049792
- Full Text :
- https://doi.org/10.1016/j.jash.2016.02.016