High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension
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High Blood Press Cardiovasc Prev · Dec 2012
Practice GuidelineRenal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure.
Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. ⋯ It consists of radiofrequency ablation of the afferent and efferent nerves of the renal sympathetic nervous system, with consequent isolation of renal parenchymal and juxtaglomerular structures from abnormal stimulation of the efferent adrenergic system. The present position paper of the Italian Society of Hypertension (SIIA) offers a diagnostic and therapeutic approach for the proper identification and effective clinical management of patients with resistant hypertension, who are candidates for renal artery denervation. These indications may have important implications not only from a clinical point of view, but also from an economic point of view, since a proper identification of patients with true resistant hypertension and an accurate selection of patients suitable for the procedure of renal denervation can contribute to an improved control of blood pressure, and thus a reduced risk of cardiovascular and cerebrovascular complications in these patients.