Abstract

ROJAS RODRIGUEZ, V  and  HOSPITAL UNIVERSITARIO LOUIS PRADEL. LYON-FRANCIA. Diplomado en formación médica especializada en Cardiología y enfermedades vasculares (DFMSA) et al. Renal denervation: A new tool to treat resistant essential hypertension.. An. Fac. Cienc. Méd. (Asunción) [online]. 2013, vol.46, n.2, pp.45-54. ISSN 1816-8949.

ABSTRACT Arterial hypertension is one of major public health problem that affects between 30% and 40% of the adult population in industrialized countries. Despite the availability of many pharmacological treatments, hypertension often remains uncontrolled. A significant percentage of patients with hypertension remain resistant to the combination of drugs, which puts them at increased risk of cardiovascular events. Renal denervation using radiofrequency with low energy by endovascular catheter, decreasing the afferent innervation and reducing blood pressure in these patients. The patients who can benefit from this technique are the ones with an uncontrolled essential hypertension despite treatment with at least a combination of antihypertensive therapy with a diuretic, and have a glomerular filtration rate greater than or equal to 45mL/min. A first study in the form of registry showed that renal denervation ablation was a simple and safe procedure, and allowed a significant and sustained reduction in blood pressure. Then, a randomized trial (the Symplicity HTN-2) showed that blood pressure in the group receiving the intervention decreased an average of 32/12mmHg, while no change was found in the control group. This decrease in blood pressure persisted at 24 months follow-up. No complications associated with the procedure, no renal artery stenosis or aneurysmal dilatation has been identified during the follow-up. No alteration or worsening renal function has been observed. This technique seems to be a real hope for these severely ill patients. We present at the end of this review the protocol of the French Society of Cardiology for management and performance of this novel procedure. Key words: Arterial hypertension; renal denervation; Sympathetic activity.

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