Is renal denervation effective in the management of hypertension?

This study reviewed the effectiveness of renal sympathetic denervation (RSD) in the treatment of hypertension. They found that this procedure was effective in reducing blood pressure. 

Hypertension or high blood pressure (BP) can be treated with a number of strategies. Lifestyle modifications and medication can be used to lower BP. Some patients may still find it difficult to control BP. This is called uncontrolled or resistant hypertension. One option for these patients is surgery.

The kidney plays an important role in regulating BP. The renal nerve sends signals to the renal artery. This can lead to a change in BP in the artery. Renal sympathetic denervation (RSD) is a surgical treatment for resistant hypertension. It uses a catheter (tube) to deliver radiofrequency (RF) waves. RF waves weaken the renal nerve. This leads to a reduction in BP. It is still unclear if RSD is an effective treatment for hypertension.

This study analyzed 6 clinical reports. 977 patients were included in the studies. In these studies, patients underwent RSD or sham surgery. ‘Sham’ surgery was a control treatment. Sham patients underwent a surgical procedure but RF waves were not used. 1 study used ultrasound waves instead of RF. Some patients were also taking medication to manage BP. BP was measured by 24-hour ambulatory (moving) BP. Both systolic and diastolic BP (SBP, DBP) were assessed. 

SBP and DBP were significantly reduced in RSD patients over 24 hours. Nighttime SBP and DBP were not different between RSD and sham patients. There was no difference in kidney function tests between the groups. 

The authors concluded that RSD was effective in reducing blood pressure.

The maximum duration of a study was 6 months. Long-term follow-up is needed to establish the effectiveness of RSD.

If you have any concerns regarding hypertension management, please consult with your doctor.