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European Society of Hypertension position paper on renal denervation 2021
- Source :
- Journal of Hypertension, 39(9), 1733-1741. LIPPINCOTT WILLIAMS & WILKINS, Journal of hypertension, Vol. 39, no. 9, p. 1733-1741 (2021)
- Publication Year :
- 2021
-
Abstract
- This ESH Position Paper 2021 with updated proposed recommendations was deemed necessary after the publication of a set of new pivotal sham-controlled randomized clinical trials (RCTs), which provided important information about the efficacy and safety of endovascular device-based renal denervation (RDN) for hypertension treatment. RDN is effective in reducing or interrupting the sympathetic signals to the kidneys and decreasing whole body sympathetic activity. Five independent, fully completed, sham-controlled RCTs provide conclusive evidence that RDN lowers ambulatory and office blood pressure (BP) to a significantly greater extent than sham treatment. BP-lowering efficacy is evident both in patients with and without concomitant antihypertensive medication. The average decrease of 10mmHg in office BP is estimated to lower the incidence of cardiovascular events by 25-30%, based on meta-analyses of RCTs using pharmacological treatment. Neither peri-procedural, nor short-term or long-term adverse events or safety signals (available up to 3 years) have been observed. Implementing RDN as an innovative third option in the armamentarium of antihypertensive treatment requires a structured process that ensures the appropriate performance of the endovascular RDN procedure and adequate selection of hypertensive patients. The latter should also incorporate patients' perspective and preference that needs to be respected in a shared decision-making process.
- Subjects :
- medicine.medical_specialty
Physiology
MEDLINE
Blood Pressure
CONTROLLED-TRIAL
Kidney
law.invention
Randomized controlled trial
law
Internal Medicine
Medicine
Humans
Sympathectomy
Intensive care medicine
Adverse effect
renal denervation
Antihypertensive Agents
Denervation
sympathetic nervous system
business.industry
DENERHTN
Blood pressure
Treatment Outcome
CATHETER
Concomitant
SAFETY
Ambulatory
Hypertension
Position paper
Cardiology and Cardiovascular Medicine
business
position paper
SYSTEM
Subjects
Details
- ISSN :
- 14735598 and 02636352
- Volume :
- 39
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Journal of hypertension
- Accession number :
- edsair.doi.dedup.....381cf593122b12ea339c5ce69af16ab3