Abstract
Resistant hypertension, defined as the failure to achieve target blood pressure despite
concurrent use of 3 antihypertensive agents of different classes, is estimated to
affect 20–30% of hypertensive patients. These patients are vulnerable to cardiovascular,
cerebrovascular and renal complications. There is ample evidence that sympathetic
nervous system hyperactivity contributes to the initiation, maintenance and progression
of hypertension. The renal sympathetic nervous system, in particular, has been identified
as a major culprit for the development and progression of hypertension, heart failure
and chronic kidney disease in both preclinical and human studies. Traditional surgical
sympathectomy proposed in 1940s was halted due to unacceptable operative risk and
the emergence of anti-hypertensive medications. Recently, catheter-based renal sympathetic
denervation by radiofrequency ablation has shown encouraging intermediate-term results
with minimal complications in patients with resistant hypertension. This review summarizes
the patho-physiological role of the renal sympathetic nervous system and the potential
application of renal denervation therapy for the treatment of resistant hypertension.
Keywords
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Article info
Publication history
Published online: February 15, 2012
Accepted:
January 22,
2012
Received:
December 21,
2011
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
