Just another hype? Renal denervation for resistant hypertension

This study examined the effects of renal denervation on blood pressure in resistant hypertensive patients.

Hypertension (high blood pressure) is increasing in prevalence worldwide. Approximately 10% of patients with diagnosed hypertension have resistant hypertension, defined as a systolic blood pressure of 140 mmHg or higher despite adherence to at least three classes of blood pressure controlling drugs.
The kidneys are known to play an important role in the development of hypertension, mainly through the constriction of renal arteries which leads to increased blood pressure.
Renal artery denervation is a minimally invasive procedure which disrupts the nerve ends within the artery wall, inhibiting constriction provoking stimuli. Small early trials have shown promising results using renal artery denervation in the treatment of resistant hypertension.

This study evaluated the effects of renal denervation on blood pressure in a large group of patients diagnosed with resistant hypertension. 535 patients were randomly assigned into 2 groups. The first group underwent renal artery denervation while the second group underwent a sham procedure (a fake surgery), and acted as the control group. Patients were unaware of whether they underwent renal artery denervation or a sham surgery. Following the procedures a 6 month follow-up was preformed, after which results were analyzed.
An average decrease in systolic blood pressure of 14.13 mmHg was noted in the renal denervation group, compared to an average decrease of 11.74 mmHg noted in the sham-procedure group. The average difference of 2.39 mmHg between treatment groups was not considered statistically significant. Similar, non-significant, results were noted when 24-hour home blood pressure monitoring was used.

This study concluded that renal denervation has no significant benefit in the management of resistant hypertension above that provided by standard medical therapy.