Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus.

Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.

[1]  J. Urquhart,et al.  Measuring, analyzing, and managing drug adherence in resistant hypertension. , 2013, Hypertension.

[2]  T. Dieterle,et al.  Blood pressure measurement--an overview. , 2012, Swiss medical weekly.

[3]  H. Krum,et al.  Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial , 2010, The Lancet.

[4]  C. Tsioufis,et al.  Abstract 19523: Catheter-Based Renal Denervation for the Treatment of Patients with Drug-Resistant Hypertension: EnligHTN I: Three-Month Data of a First in Man Study Using a Multi-Electrode Radiofrequency Ablation Catheter , 2012 .

[5]  R. Agarwal,et al.  Renal Sympathetic Denervation for Treatment of Resistant Hypertension: A Systematic Review , 2013, Journal of clinical hypertension.

[6]  A. Dominiczak,et al.  2007 ESH‐ESC Guidelines for the management of arterial hypertension , 2007 .

[7]  W. Elliott.  Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring , 2012 .

[8]  P. Anyfanti,et al.  Should ambulatory blood pressure monitoring be mandatory for future studies in resistant hypertension: a perspective. , 2012, Journal of hypertension.

[9]  J. Banegas,et al.  Clinical Features of 8295 Patients With Resistant Hypertension Classified on the Basis of Ambulatory Blood Pressure Monitoring , 2011, Hypertension.

[10]  S. Bertog,et al.  Renal artery stenosis after renal sympathetic denervation. , 2012, Journal of the American College of Cardiology.

[11]  W. Elliott.  Resistant Hypertension: Diagnosis, Evaluation, and Treatment: A Scientific Statement From the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research , 2009 .

[12]  G. Parati,et al.  ESH position paper: renal denervation - an interventional therapy of resistant hypertension. , 2012, Journal of hypertension.

[13]  H. Black,et al.  Resistant hypertension in a tertiary care clinic. , 1991, Archives of internal medicine.

[14]  Deepak L. Bhatt,et al.  Catheter‐Based Renal Denervation for Resistant Hypertension: Rationale and Design of the SYMPLICITY HTN‐3 Trial , 2012, Clinical cardiology.

[15]  Dominik Linz,et al.  Renal Hemodynamics and Renal Function After Catheter-Based Renal Sympathetic Denervation in Patients With Resistant Hypertension , 2012, Hypertension.

[16]  Symplicity Htn Investigators,et al.  Catheter-Based Renal Sympathetic Denervation for Resistant Hypertension: Durability of Blood Pressure Reduction Out to 24 Months , 2011, Hypertension.

[17]  G. Dibona,et al.  Neural control of renal function. , 2011, Comprehensive Physiology.

[18]  M. Böhm,et al.  Renal sympathetic denervation reduces left ventricular hypertrophy and improves cardiac function in patients with resistant hypertension. , 2012, Journal of the American College of Cardiology.

[19]  T. Lüscher,et al.  Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity® catheter system and the EnligHTN™ multi-electrode renal denervation catheter , 2013, European heart journal.

[20]  F. Paccaud,et al.  Swiss survey on salt intake : main results , 2011 .

[21]  Krzysztof Bartus,et al.  Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study , 2009, The Lancet.

[22]  M. Burnier,et al.  Electronic compliance monitoring in resistant hypertension: the basis for rational therapeutic decisions , 2001, Journal of hypertension.

[23]  H. Krum,et al.  Renal sympathetic denervation for treatment of drug-resistant hypertension: one-year results from the Symplicity HTN-2 randomized, controlled trial. , 2012, Circulation.

[24]  H. Krum,et al.  Device-Based Antihypertensive Therapy: Therapeutic Modulation of the Autonomic Nervous System , 2011, Circulation.

[25]  J. Staessen,et al.  Blood pressure changes after renal denervation at 10 European expert centers , 2013, Journal of Human Hypertension.

[26]  G. Parati,et al.  International expert consensus statement: Percutaneous transluminal renal denervation for the treatment of resistant hypertension. , 2013, Journal of the American College of Cardiology.

[27]  B. Williams,et al.  Expert consensus document from the European Society of Cardiology on catheter-based renal denervation. , 2013, European heart journal.

[28]  E. Vink,et al.  Eligibility for percutaneous renal denervation: the importance of a systematic screening , 2013, Journal of hypertension.

[29]  M. Böhm,et al.  Effects of renal sympathetic denervation on arterial stiffness and central hemodynamics in patients with resistant hypertension. , 2012, Journal of the American College of Cardiology.

[30]  A. Dominiczak,et al.  2007 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) , 2007, European heart journal.

[31]  Heather M. Tavel,et al.  Incidence and Prognosis of Resistant Hypertension in Hypertensive Patients , 2012, Circulation.

[32]  H. Krum,et al.  Ambulatory Blood Pressure Changes After Renal Sympathetic Denervation in Patients With Resistant Hypertension , 2013, Circulation.

[33]  J. Staessen,et al.  Renal denervation: time to open Pandora's box. , 2012, Swiss medical weekly.

[34]  H. Krum,et al.  Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension: A Pilot Study , 2011, Circulation.

[35]  D. Blondin,et al.  Secondary rise in blood pressure after renal denervation , 2012, The Lancet.

[36]  G. Bobrie,et al.  Eligibility for renal denervation in patients with resistant hypertension: when enthusiasm meets reality in real-life patients. , 2012, Journal of the American College of Cardiology.