Updated ESH position paper on interventional therapy of resistant hypertension

EuroIntervention. 2013 May:9 Suppl R:R58-66. doi: 10.4244/EIJV9SRA11.

Abstract

Out of the overall hypertensive population it is estimated that approximately 10% have treatment resistant hypertension (TRH). Percutaneous catheter-based transluminal renal ablation (renal denervation [RDN] by delivery of radiofrequency energy) has emerged as a new approach to achieve sustained blood pressure reduction in patients with TRH. This innovative interventional technique is now available across Europe for severe TRH for those patients in whom pharmacologic strategies and lifestyle changes have failed to control blood pressure below target (usually <140/90 mmHg). In 2012, the "ESH position paper: renal denervation - an interventional therapy of resistant hypertension" was published to facilitate a better understanding of the effectiveness, safety, limitation and unresolved issues. We have now updated this position paper since numerous studies have been published over the last year providing more data about the rationale, therapeutic efficacy and safety of RDN. In the upcoming ESH/ESC guidelines for the management of arterial hypertension, therapeutic options of treatment resistant hypertension will be addressed, but only briefly, and thus it is the focus of this paper to provide detailed and updated information on this innovative interventional technique.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Blood Pressure Monitoring, Ambulatory
  • Blood Pressure* / drug effects
  • Catheter Ablation / adverse effects
  • Catheter Ablation / standards*
  • Drug Resistance
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / physiopathology
  • Hypertension / surgery*
  • Kidney / innervation*
  • Predictive Value of Tests
  • Sympathectomy / adverse effects
  • Sympathectomy / standards*
  • Sympathetic Nervous System / physiopathology
  • Sympathetic Nervous System / surgery*
  • Treatment Outcome

Substances

  • Antihypertensive Agents