Abstract

RENAL DENERVATION AS A THERAPEUTIC APPROACH FOR MANAGING RESISTANT HYPERTENSION: A COMPHRENSIVE REVIEW

Amulya Kanchibhotla*, Anusha Gunji, Subhiksha Panditi, Rajyalakshmi Penumala, Bolla Bhavani and Padmalatha Kantamaneni

ABSTRACT

Hypertension is a world-wide leading risk factor for developing cerebrovascular, cardiovascular, renal disorders as well as mortality. Low adherence to treatment is leading to uncontrolled hypertension. Despite the availability of both pharmacological and lifestyle therapeutic options, blood pressure control rates across the world are worsening. Some group of patients also develop adverse reactions to many anti-hypertensive medications and some may develop resistance. In majority of patients hypertension is associated with an increased systemic sympathetic activity. Especially the sympathetic nervous system of the kidney plays a key role in the pathogenesis of hypertension. In the year 2023, the US Food and Drug Administration approved renal denervation as an alternative approach for treating patients in whom lifestyle modifications and antihypertensive medications do not control blood pressure. Renal denervation involves catheterization of the renal arteries and using either a radiofrequency-Hypertension is a world-wide leading risk factor for developing cerebrovascular, cardiovascular, renal disorders as well as mortality. Low adherence to treatment is leading to uncontrolled hypertension. Despite the availability of both pharmacological and lifestyle therapeutic options, blood pressure control rates across the world are worsening. Some group of patients also develop adverse reactions to many anti-hypertensive medications and some may develop resistance. In majority of patients hypertension is associated with an increased systemic sympathetic activity. Especially the sympathetic nervous system of the kidney plays a key role in the pathogenesis of hypertension. In the year 2023, the US Food and Drug Administration approved renal denervation as an alternative approach for treating patients in whom lifestyle modifications and antihypertensive medications do not control blood pressure. Renal denervation involves catheterization of the renal arteries and using either a radiofrequency-fall in systemic blood pressure. Renal denervation hasn’t shown significant impact on blood pressure reduction since it is an invasive procedure the risk/benefit ratio must be clearly defined. It should also be avoided in patients with an unsuitable anatomy of the renal artery/access site or any condition that would increase the risk of the procedure, such as a bleeding disorder.

Keywords: Hypertension, Reznal denervation, Resistant hypertension, Sympathetic nervous system.