Herz
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Hypertension is a well-known risk factor for major cardiovascular events. Despite advances in medical therapy, sufficient treatment of hypertension remains unsatisfying in a substantial number of patients and is therefore one of the main challenges in modern medicine. In Germany 5-15 % of patients with hypertension suffer from resistant hypertension with elevated blood pressure despite the use of at least three antihypertensive drugs. ⋯ Moreover, by reducing the sympathetic activity after renal denervation early results indicate a positive impact on glucose metabolism, sleep apnea syndrome, as well as heart and renal failure. These effects led to the development of many different devices for renal denervation; however, trials with a higher number of patients and longer follow-up need to confirm these initially promising results and the value of newer devices. Until then renal denervation should not be regarded as standard therapy for arterial hypertension or an alternative to medical antihypertensive treatment and should be reserved for selected patients with resistant hypertension and specialized medical centres.