A new treatment for resistant hypertension: catheter-based renal sympathetic denervation (RSD)

This study evaluated a new therapy called catheter-based renal sympathetic denervation (RSD) for patients with resistant high blood pressure.

Hypertension is a condition in which blood pressure (BP) exceeds 140/90 mmHg at rest. Systolic blood pressure (SBP) is the higher value (measured while the heart contracts), whereas diastolic pressure (DBP) refers to the lower value (measured when the heart is relaxed). Ambulatory blood pressure (ABP) measures a patient's blood pressure frequently over a 24-hour period. Treatment resistant hypertension (TRH) is defined as persistently high SBP (over 160 mmHg) despite taking three or more medications (one of them a diuretic). Patients with pseudo treatment resistant hypertension (pTRH) have high blood pressure at the office, but once they go home, they have normal blood pressure on ABP. Catheter-based renal sympathetic denervation (RSD) is an experimental procedure that uses energy pulses to destroy the nerves responsible for increasing blood pressure to the kidneys. As a result, the systemic blood pressure is reduced as well. It is not yet FDA approved.

This study looked at 346 patients with TRH and pTRH. All participants undergone catheter-based RSD procedure, and then monitored three times a year. Both groups had large drops in their office-measured blood pressure, SBP drop of 21.5; 23.7; 27.3 (at 3, 6 and 12 months respectively) and DBP of 8.5; 9.3; 11.7. The average blood pressure in the TRH group was reduced throughout the day, while the pTRH group had drops only in their office based blood pressure, but their normal home pressures remained normal.

Catheter-based renal sympathetic denervation offers patients with resistant hypertension a sustained, substantial decrease in systolic and diastolic blood pressure.

If you suffer from resistant hypertension, talk to your doctor about other, perhaps experimental treatment options, such as RSD.