Novel technique. Interventional renal sympathetic denervation for resistant hypertension

Hyperactivity of the sympathetic nervous system has been shown as one of the factors contributing to the complex pathophysiology of resistant hypertension. Preliminary data demonstrate that in these patients catheter-based renal sympathetic denervation can significantly attenuate sympathetic activity and result in marked and sustained blood pressure reduction. The ongoing randomized Symplicity-HTN-2 trial enrolls patients with office systolic blood pressure of 160 mmHg or more (150 mmHg for patients with type 2 diabetes), despite at least a triple antihy-pertensive drug regimen. Based on a plausible pathophysiological concept, interventional sympathetic renal denervation is safe, effective and easy to perform and might offer benefits in other areas as well, e.g., in patients with diabetes, chronic heart failure or end-stage renal disease.