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International Journal of Hypertension
Volume 2011, Article ID 196518, 8 pages
http://dx.doi.org/10.4061/2011/196518
Review Article

Renal Sympathetic Denervation for the Treatment of Difficult-to-Control or Resistant Hypertension

1Veterans Affairs and Georgetown University Medical Centers, 50 Irving Street, Washington, DC 20422, USA
2Aristotle University of Thessaloniki, Thessaloniki, Greece
3National and Kapodistrian University of Athens, Athens, Greece

Received 1 October 2010; Revised 22 December 2010; Accepted 19 January 2011

Academic Editor: Alan Gradman

Copyright © 2011 Vasilios Papademetriou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hypertension represents a major health problem with an appalling annual toll. Despite the plethora of antihypertensive drugs, hypertension remains resistant in a considerable number of patients, thus creating the need for alternative strategies, including interventional approaches. Recently, catheter-based renal sympathetic denervation has been shown to be fairly safe and effective in patients with resistant hypertension. Pathophysiology of kidney function, interaction and crosstalk between the kidney and the brain, justifies the use of renal sympathetic denervation in the treatment of hypertension. Data from older studies have shown that sympathectomy has effectively lowered blood pressure and prolonged life expectancy of hypertensive patients, but at considerable cost. Renal sympathetic denervation is devoid of the adverse effects of surgical sympathectomy, due to its localized nature, is minimally invasive, and provides short procedural and recovery times. This paper outlines the pathophysiological background for renal sympathetic denervation, describes the past and the present of this interventional approach, and considers several future potential applications.