Renal Denervation Therapies for Refractory Hypertension

The treatment of severe hypertension by the surgical obliteration of the renal sympathetic nerves was proposed almost 80 years ago. This approach, although highly effective in reducing blood pressure was associated with a significant amount of side effects and it was rapidly replaced by better toler...

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Bibliographic Details
Published inCurrent cardiology reports Vol. 14; no. 5; pp. 619 - 625
Main Authors Granada, Juan F., Buszman, Piotr P.
Format Journal Article
LanguageEnglish
Published New York Current Science Inc 01.10.2012
Subjects
Cardiology
Catheter Ablation - methods
Humans
Hypertension - physiopathology
Hypertension - surgery
Interventional Cardiology (DJ Moliterno
Kidney - innervation
Kidney - surgery
Medicine
Medicine & Public Health
Section Editor
Sympathectomy - methods
Sympathetic Nervous System - physiopathology
Sympathetic Nervous System - surgery
Treatment Outcome
Renal denervation
Hypertension
Renal nerve ablation
Glucose metabolism
Cardiovascular
Left ventricular hypertrophy
Activation
Blood pressure
Refractory hypertension
Novel denervation therapies
Sympathetic
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Summary:The treatment of severe hypertension by the surgical obliteration of the renal sympathetic nerves was proposed almost 80 years ago. This approach, although highly effective in reducing blood pressure was associated with a significant amount of side effects and it was rapidly replaced by better tolerated medical therapy. The rapid progress in catheter based technologies occurring within the last 20 years facilitated the development of the first radio frequency renal artery denervation catheter. At the present time, several small trials have demonstrated the safety and efficacy of this approach among patients with refractory hypertension. Besides its effect on reducing blood pressure, other pleiotropic effects (ie, improving glycemia in diabetic patients) have been proposed. In this review, we discuss the anatomical and physiological rationale for this therapy, provide an update on the latest clinical data available and describe additional emerging technologies in this field.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ISSN:1523-3782
1534-3170
DOI:10.1007/s11886-012-0303-9