Renal denervation techniques to treat resistant hypertension

This study investigated the effectiveness of renal sympathetic denervation (RDN) techniques in resistant hypertension. They found that endovascular ultrasound (EU)-RDN was more effective than radiofrequency (RF)-RDN.

Hypertension or high blood pressure (BP) can be treated using a number of strategies. Medication and lifestyle adjustments are frequently prescribed by doctors. Some patients do not respond to any medication. This is called resistant hypertension (RT).

RT can be difficult to treat. Surgical treatment is an option for these patients. A procedure called renal sympathetic denervation (RDN) can improve RT. RDN involves using a technique to ‘kill’ (denervate) a nerve that controls the renal (kidney) artery. This prevents the nerve from signaling to the artery and BP is reduced. RDN can be performed using two different methods. Radiofrequency (RF)-RDN uses magnetic waves to denervate the nerve. Endovascular ultrasound (EU)-RDN uses ultrasound waves to denervate the nerve. It Is unclear if RF-RDN or EU-RDN is more effective in patients with RT.

This study included 120 patients with RT. Patients were randomly assigned to undergo RF-RDN or EU-RDN. Patients in the RF-RDN group underwent total (main artery and smaller vessels) or partial (main artery) RDN. Follow-up was performed at 1 and 3 months. At 3 months BP was measured. 

BP was significantly lower in all patients at 3 months. EU-RDN reduced BP more than RF-RDN. There was no difference in BP after total or partial RF-RDN. There were no serious side effects associated with the procedures. 

The authors concluded that EU-RDN was more effective than RF-RDN in patients with resistant hypertension.

This is a relatively small study. Larger studies are needed to confirm these findings. This study was performed in one hospital. RDN protocols may differ across other centers. 

If you have any concerns regarding resistant hypertension, please consult with your physician.