Renal artery denervation (RDN) for uncontrolled bloodpressure –looking beyond medical therapy

Systemic Hypertension is a global health issue and over 30% of adults worldwide are suffering from it. Diet and the lifestyle modification plays an important role in the management of Hypertension. Medical therapy with antihypertensive medications is required in majority of the patients with Hypertension.

Why is blood pressure not controlled in some of the patients despite following lifestyle modification and medical therapy?

Poor compliance to diet, lifestyle and medical therapy is the most common reason for uncontrolled blood pressure. Around 30% of the patients have uncontrolled blood pressure despite of taking medications regularly. Many of these patients are on 3 to 5 medications but blood pressure is not under control. It is well proven that kidneys play an essential role in maintaining blood pressure and overactivity of the sympathetic nerves in the kidney arteries is responsible for uncontrolled or resistant hypertension.

 

What is Renal artery denervation (RDN)?

The renal denervation (RDN) procedure – known as the Symplicity™ blood pressure procedure – is a minimally invasive technique that targets nerves near the kidneys that can become overactive and cause elevated blood pressure. In this procedure, a small catheter(wire like device) is inserted through a tiny puncture in to the right groin artery and is taken up to the kidney artery. The doctor then uses the catheter to calm the excessive activity of the nerves connected to the kidney. The tube is removed, leaving no implant behind. The Symplicity blood pressure procedure is a proven way to help reduce blood pressure.

 

How is the efficacy and safety of this procedure?

The clinical data from Symplicity trials and the real world practice has shown that RDN is highly effective in controlling blood pressure and more importantly the number of antihypertensive medications come down significantly after the therapy. The results of RDN therapy are long lasting with continued benefits as long as 10 years post therapy. The RDN procedure is generally very safe and no major complications and adverse effects noted during the procedure and on follow-up. Considering the efficacy and safety of the procedure, US FDA has approved the Symplicity based Renal denervation therapy for management of uncontrolled hypertension in December 2023.

 

Who is an ideal candidate for RDN?

1. Patients with resistant or uncontrolled blood pressure despite of taking multiple medications.

2. Patients with high blood pressure and are unable to take medications due to adverse effects of drugs.

Overall RDN therapy has come as a new ray of hope for Patients with uncontrolled Hypertension. Timely intervention and blood pressure control can prevent many dreaded complications like myocardial infarction (heart attack), heart failure strokes, kidney failures and retinopathy (loss of vision).

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