Controversies Surrounding Renal Denervation: Lessons Learned From Real-World Experience in Two United Kingdom Centers

Amy E Burchell, Kenneth Chan, Laura E K Ratcliffe, Emma C. Hart, Manish Saxena, David J. Collier, Ajay K. Jain, Anthony Mathur, Charles J. Knight, Mark J. Caulfield, Julian F R Paton, Angus K Nightingale, Melvin D. Lobo*, Andreas Baumbach

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

5 Citations (Scopus)
252 Downloads (Pure)

Abstract

Renal denervation (RDN) is a therapy that targets treatment-resistant hypertension (TRH). The Renal Denervation in Patients With Uncontrolled Hypertension (Symplicity) HTN-1 and Symplicity HTN-2 trials reported response rates of >80%; however, sham-controlled Symplicity HTN-3 failed to reach its primary blood pressure (BP) outcome. The authors address the current controversies surrounding RDN, illustrated with real-world data from two centers in the United Kingdom. In this cohort, 52% of patients responded to RDN, with a 13±32 mm Hg reduction in office systolic BP (SBP) at 6 months (n=29, P=.03). Baseline office SBP and number of ablations correlated with office SBP reduction (R=-0.47, P=.01; R=-0.56, P=.002). RDN appears to be an effective treatment for some patients with TRH; however, individual responses are highly variable. Selecting patients for RDN is challenging, with only 10% (33 of 321) of the screened patients eligible for the study. Medication alterations and nonadherence confound outcomes. Adequate ablation is critical and should impact future catheter design/training. Markers of procedural success and improved patient selection parameters remain key research aims.

Original languageEnglish
Pages (from-to)585-592
Number of pages8
JournalJournal of Clinical Hypertension
Volume18
Issue number6
Early online date9 Feb 2016
DOIs
Publication statusPublished - 4 Jun 2016

Structured keywords

  • CRICBristol
  • Bristol Heart Institute

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