I read with great interest the article by Khan et al., published online in advance of print in the Canadian Journal of Cardiology.
1This article presents a position statement on renal denervation by the Canadian Hypertension Education Program, and stated that “the limited trial data published to date have shown clinically significant reduction in BP (blood pressure).” However, the authors did not cite references with different results. For example, in 2012, Brinkmann and colleagues showed that renal denervation (n = 12) did not decrease office systolic blood pressure (157 mm Hg vs 157 mm Hg, for baseline and 3-6 months after the procedure).
- Khan N.A.
- Herman R.J.
- Quinn R.R.
- et al.
Renal denervation therapy for the treatment of resistant hypertension: a position statement by the Canadian Hypertension Education Program.
Can J Cardiol. 2014; 30: 16-21
2Shortly after the acceptance of this position paper, Drs Fadl Elmula and Hart separately reported that renal denervation non-significantly decreased office systolic blood pressure by 7-8 mm Hg six months after the procedure (P > 0.05 for both studies).
- Brinkmann J.
- Heusser K.
- Schmidt B.M.
- et al.
Catheter-based renal nerve ablation and centrally generated sympathetic activity in difficult-to-control hypertensive patients: prospective case series.
Hypertension. 2012; 60: 1485-1490
- Fadl Elmula F.E.
- Hoffmann P.
- Fossum E.
- et al.
Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure.
Hypertension. 2013; 62: 526-532
- Hart E.C.
- McBryde F.D.
- Burchell A.E.
- et al.
Translational examination of changes in baroreflex function after renal denervation in hypertensive rats and humans.
Hypertension. 2013; 62: 533-541
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- Renal denervation therapy for the treatment of resistant hypertension: a position statement by the Canadian Hypertension Education Program.Can J Cardiol. 2014; 30: 16-21
- Catheter-based renal nerve ablation and centrally generated sympathetic activity in difficult-to-control hypertensive patients: prospective case series.Hypertension. 2012; 60: 1485-1490
- Renal sympathetic denervation in patients with treatment-resistant hypertension after witnessed intake of medication before qualifying ambulatory blood pressure.Hypertension. 2013; 62: 526-532
- Translational examination of changes in baroreflex function after renal denervation in hypertensive rats and humans.Hypertension. 2013; 62: 533-541
Published online: January 06, 2014
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
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- Renal Denervation Therapy for the Treatment of Resistant Hypertension: A Position Statement by the Canadian Hypertension Education ProgramCanadian Journal of CardiologyVol. 30Issue 1
- PreviewRenal denervation is a novel catheter-based, percutaneous procedure using radiofrequency energy to ablate nerves within the renal arteries. This procedure might help to significantly lower blood pressure (BP) in patients with resistant hypertension, defined as BP > 140/90 mm Hg (> 130/80 mm Hg for those with diabetes) despite use of ≥ 3 optimally dosed antihypertensive agents, ideally including 1 diuretic agent. The Canadian Hypertension Education Program Recommendations Task Force reviewed the current evidence on safety and efficacy of this procedure.