Perelman School of Medicine, Renal, Electrolyte and Hypertension Division, University of Pennsylvania, 122 Founders Building, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
The Ohio State, Columbus, OH, USA.
Curr Hypertens Rep. 2018 Sep 10;20(11):93. doi: 10.1007/s11906-018-0896-5.
This review was undertaken to update readers on the field of therapeutic renal denervation for hypertension during the 2016 through 2018 period.
After the failure of Symplicity HTN-3 to meet its top line objective, intense scrutiny revealed several possible concerns addressed by the newer investigations into the area of renal denervation. These included better device technology, more intense subject monitoring for off-protocol antihypertensive drug usage, and deeper penetration into the renal vasculature by the interventionist. Whether untreated by medication for hypertension or on antihypertensive medication, renal denervation shows a clear, though moderate, blood pressure reduction. The failure of roughly one out of three patients with hypertension to respond to denervation procedures argues that there is room for improvement in choosing the optimal patient for this approach to hypertension management.
本综述旨在介绍 2016 年至 2018 年期间治疗性肾脏去神经支配治疗高血压领域的最新进展。
Symplicity HTN-3 未能达到其主要目标后，对该领域的进一步研究发现了一些可能存在的问题。这些问题包括更好的设备技术、更严格地监测受试者是否违反治疗方案使用降压药物以及介入医师更深地进入肾血管。无论高血压患者是否未接受药物治疗或正在服用降压药物，肾脏去神经支配都能明显降低血压，但程度适中。大约三分之一的高血压患者对去神经支配手术无反应，这表明在选择最佳患者接受这种高血压管理方法方面还有改进的空间。
