First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens. Greece.
2ndPropedeutic Department of Internal Medicine, Aristotle University, Thessaloniki. Greece.
Curr Vasc Pharmacol. 2017;16(1):66-69. doi: 10.2174/1570161115666170426151649.
Although the first results from studies suggested important benefits regarding blood pressure (BP) control in resistant hypertension by the use of diverse systems of renal denervation (RDN) in the setting of resistant hypertension, the Symplicity HTN-3, randomized sham-controlled trial reduced the enthusiasm and led to a more critical approach towards this neuromodulation innovative therapy. Nowadays there is an ongoing research attempt to justify the pathophysiological background of RDN since overdrive of the sympathetic nervous system is one of the key mechanisms leading to the development and progression of the hypertensive and cardiovascular diseases.
Future RDN trials based on the clinical findings and gaps from previous works will try to identify those parameters to help identify better BP response, target the most suitable population and conclude whether this interventional approach can contribute to the clinical problem of uncontrolled hypertension.
尽管最初的研究结果表明,在难治性高血压患者中使用各种类型的肾去神经术(RDN)系统,对血压(BP)控制有重要的益处,但 Symplicity HTN-3 随机假手术对照试验降低了人们的热情,并导致对这种神经调节创新疗法采取更为谨慎的方法。如今,人们正在进行研究,试图从生理学上解释 RDN 的作用机制,因为交感神经系统的过度兴奋是导致高血压和心血管疾病发展和进展的关键机制之一。
基于之前研究的临床发现和空白,未来的 RDN 试验将试图确定这些参数,以帮助确定更好的血压反应,确定最合适的人群,并得出这种介入方法是否可以解决高血压控制不佳的临床问题。