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Renal denervation as therapy for hypertension
Huan, Yonghong Renal, Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Cohen, Debbie L. Renal, Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
- Renal sympathetic hyperactivity and hypertension
- Description and results
- Related Primary Literature
- Additional Reading
Hypertension is a growing public health problem and remains a leading cause of cardiovascular diseases. The sympathetic nervous system (SNS), which is part of the autonomic nervous system, has long been recognized as playing an important role in the pathogenesis of hypertension. Invasive and nonspecific surgical sympathectomy (disruption of the sympathetic nerves) was performed successfully several decades ago to improve the survival of patients with severe hypertension and related complications. However, surgical sympathectomy had high rates of complications and severe side effects [including postural hypotension (a drop in blood pressure due to a change in body position), impotence, and incontinence], and it was largely abandoned after the advent of modern pharmacological therapy for hypertension. Despite the availability of several classes of effective antihypertensive medications, resistant hypertension remains common and accounts for approximately 10–12% of all drug-treated hypertension. Minimally invasive and targeted renal denervation (disruption of the renal sympathetic nerves) is now possible with a catheter-based approach, and clinical trials have shown impressive blood pressure (BP) reductions and favorable side-effect profiles in the treatment of drug-resistant hypertension.
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