TY - JOUR
T1 - Italian Society of Arterial Hypertension (SIIA) Position Paper on the Role of Renal Denervation in the Management of the Difficult-to-Treat Hypertensive Patient
AU - Bruno, Rosa Maria
AU - Taddei, Stefano
AU - Borghi, Claudio
AU - Colivicchi, Furio
AU - Desideri, Giovambattista
AU - Grassi, Guido
AU - Mazza, Alberto
AU - Muiesan, Maria Lorenza
AU - Parati, Gianfranco
AU - Pontremoli, Roberto
AU - Trimarco, Bruno
AU - Volpe, Massimo
AU - Ferri, Claudio
PY - 2020/4
Y1 - 2020/4
N2 - Renal denervation is a device-based procedure for hypertension for which safety and efficacy has been demonstrated. At present, its clinical use is still matter of debate, despite the most recent clinical trials have shown promising results with new-generation devices in various hypertensive populations. This position paper was deemed necessary by the Italian Society of Arterial Hypertension, in order to provide indications about the applications of renal denervation in the clinical setting. A state-of-the art review of the literature, focusing on safety and efficacy data, is provided. Furthermore, based on current evidence and expert consensus, clinical profiles of possible candidates for renal denervation are proposed. The selection process should take into account not only blood pressure values, global cardiovascular risk profile, but also drug adherence and tolerability and patient preferences. This position paper also defines minimum requirements for renal denervation selection centers and a flowchart for the difficult-to-treat hypertensive patient. Further studies are needed to support these preliminary indications, which are based on expert-consensus only.
AB - Renal denervation is a device-based procedure for hypertension for which safety and efficacy has been demonstrated. At present, its clinical use is still matter of debate, despite the most recent clinical trials have shown promising results with new-generation devices in various hypertensive populations. This position paper was deemed necessary by the Italian Society of Arterial Hypertension, in order to provide indications about the applications of renal denervation in the clinical setting. A state-of-the art review of the literature, focusing on safety and efficacy data, is provided. Furthermore, based on current evidence and expert consensus, clinical profiles of possible candidates for renal denervation are proposed. The selection process should take into account not only blood pressure values, global cardiovascular risk profile, but also drug adherence and tolerability and patient preferences. This position paper also defines minimum requirements for renal denervation selection centers and a flowchart for the difficult-to-treat hypertensive patient. Further studies are needed to support these preliminary indications, which are based on expert-consensus only.
KW - Ablation Techniques/adverse effects
KW - Antihypertensive Agents/therapeutic use
KW - Arterial Pressure/drug effects
KW - Clinical Decision-Making
KW - Decision Support Techniques
KW - Drug Resistance
KW - Humans
KW - Hypertension/diagnosis
KW - Kidney/blood supply
KW - Medication Adherence
KW - Patient Safety
KW - Patient Selection
KW - Renal Artery/innervation
KW - Risk Factors
KW - Sympathectomy/adverse effects
KW - Treatment Outcome
U2 - 10.1007/s40292-020-00367-0
DO - 10.1007/s40292-020-00367-0
M3 - Review article
C2 - 32157642
VL - 27
SP - 109
EP - 117
JO - High Blood Pressure and Cardiovascular Prevention
JF - High Blood Pressure and Cardiovascular Prevention
SN - 1120-9879
IS - 2
ER -