Renal denervation in the antihypertensive arsenal - knowns and known unknowns

Franz H. Messerli, Chirag Bavishi, Jana Brguljan, Michel Burnier, Stephan Dobner, Fernando Elijovich, Keith C. Ferdinand, Sverre Kjeldsen, Cheryl L. Laffer, C. Venkata S Ram, Emrush Rexhaj, Luis M. Ruilope, Evgeniya V. Shalaeva, George C.M. Siontis, Jan A. Staessen, Stephen C. Textor, Wanpen Vongpatanasin, Liffert Vogt, Massimo Volpe, Jiguang WangBryan Williams

Research output: Contribution to journalArticlepeer-review


Even though it has been more than a decade since renal denervation (RDN) was first used to treat hypertension and an intense effort on researching this therapy has been made, it is still not clear how RDN fits into the antihypertensive arsenal. There is no question that RDN lowers blood pressure (BP), it does so to an extent at best corresponding to one antihypertensive drug. The procedure has an excellent safety record. However, it remains clinically impossible to predict whose BP responds to RDN and whose does not. Long-term efficacy data on BP reduction are still unconvincing despite the recent results in the SPYRAL HTN-ON MED trial; experimental studies indicate that reinnervation is occurring after RDN. Although BP is an acceptable surrogate endpoint, there is complete lack of outcome data with RDN. Clear indications for RDN are lacking although patients with resistant hypertension, those with documented increase in activity of the sympathetic system and perhaps those who desire to take fewest medication may be considered.

Original languageEnglish (US)
Pages (from-to)1859-1875
Number of pages17
JournalJournal of hypertension
Issue number10
StatePublished - Oct 1 2022


  • antihypertensive treatment
  • blood pressure
  • hypertension
  • refractory hypertension
  • renal denervation

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine


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