Interv Akut Kardiol. 2019;18(3):143-148 | DOI: 10.36290/kar.2019.036

Renal denervation in the treatment of resistant hypertension: a new dawn?

David Richter, Miloš Táborský, Marián Fedorco, David Vindiš, Jan Václavík, Eva Kociánová, Marie Lazárová, Jiří Ostřanský, Martin Sluka, Radomír Nykl, Miloš Špaček, Rostislav Stříbrný

I. interní klinika – kardiologická, Fakultní nemocnice Olomouc

Hypertension is a serious cardiovascular risk factor, and because of its high incidence in adults (30–40 %), its treatment is also a major medical and economic problem. Sympathicotonia plays a key role in the etiopathogenesis of hypertension. Currently, pharmacotherapy is the mainstay of hypertension treatment. Historically, however, the first truly effective treatment of hypertension, including malignant hypertension, was surgical sympathectomy. Unfortunately, surgical sympathectomy was often complicated by serious or fatal complications, and was abandoned with the advent of modern pharmacotherapy. Catheter-based renal denervation is based on the concept of mini-invasive partial renal sympathectomy. Introduced for the first time in 2009, renal denervation has undergone its historical development: from inadequate initial euphoria to subsequent rejection to contemporary renaissance. Currently, renal denervation appears to be an effective adjunctive non-pharmacological treatment in a selected group of patients with true primary resistant hypertension, in whom “maximum combined pharmacotherapy alone” fails to achieve target blood pressure levels.

Keywords: hypertension, sympathicotonia, renal denervation, resistant hypertension

Published: November 1, 2019  Show citation