|
| Inclusion |
| (i) Age 30 to 70 years |
| (ii) One month of stable antihypertensive treatment with at least three antihypertensive agents including a diuretic (or in case of diuretic intolerance, a minimum of three nondiuretic antihypertensive drugs) |
| (iii) Daytime ABPM systolic blood pressure ≥ 145 mmHg (preceded by 1 month of scheduled drug intake showing at least 85% adherence) |
| Exclusion |
| General |
| (i) Noncompliant personality (abuse, mental illness) |
| (ii) Pregnancy/inadequate contraception in fertile women |
| (iii) Known allergy to iodine-containing X-ray contrast agent |
| Comorbidity |
| (i) Diabetes |
| (ii) Secondary hypertension |
| (iii) Malignant disease |
| (iv) Congestive heart failure NYHA 3-4 |
| (v) Chronic renal failure stages 4-5 (eGFR ≤ 30 ml/min/1.73m2) |
| (vi) Stable angina pectoris (CCS classes 2–4) |
| (vii) Unstable angina pectoris |
| (viii) Coronary artery disease with indication for coronary intervention |
| (ix) Recent myocardial infarction or coronary intervention (<6 months) |
| (x) Permanent atrial fibrillation |
| (xi) Orthostatic syncope (<6 months) |
| (xii) Symptomatic peripheral artery disease |
| Paraclinical |
| (i) Clinically significant abnormal electrolytes and liver function tests. |
| (ii) Hemoglobin < 7.0 mmol/l |
| (iii) Abnormal thyroid function |
| (iv) Macroscopic haematuria |
| (v) ECG: AV-block grades 2 and 3 or AV-block grades 1 + branch block |
| Echocardiography |
| (i) Left ventricular ejection fraction < 50% |
| (ii) Significant valvular disease |
| CT-angiography and selective angiography of renal arteries |
| (i) Pronounced calcification in iliaco-aortic or renal arteries |
| (ii) Multiple renal arteries: accessory renal arteries estimated to carry more than 10% of the kidney’s blood supply (small polar arteries accepted) and being undersized (see below) for ablation procedure |
| (iii) Renal artery diameter < 4 mm |
| (iv) Renal artery length (from ostium to first major side branch) < 20 mm |
| (v) Renal artery disease (stenosis, fibromuscular dysplasia; prior intervention, dissection) |
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