Renal Denervation for Hypertension

Systemic hypertension is a major burden to the individual and society. Its association with major adverse cardiac and cerebral events and favorable effects of antihypertensive therapy are undisputed. However, despite multidrug therapy, blood pressures are frequently suboptimally controlled. Moreover, adverse drug effects often interfere with patients' lifestyles and affect compliance. Therefore, alternative treatment strategies have been explored. Most recently, attention has been redirected to the sympathetic nervous system (SNS) in the pathogenesis of hypertension. In addition, interruption of the renal SNS in humans with resistant hypertension has been studied with promising results. The following review provides an overview of the anatomy and physiology of the renal SNS, the rational for manipulating the SNS, and the results of therapeutic renal sympathetic denervation. (J Am Coll Cardiol Intv 2012;5:249-58) (C) 2012 by the American College of Cardiology Foundation