Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia.
University of Sydney, Sydney, NSW, Australia.
Heart Lung Circ. 2020 Jan;29(1):94-101. doi: 10.1016/j.hlc.2019.06.723. Epub 2019 Jul 9.
Early studies of renal artery denervation (RAD) demonstrated efficacy in treating resistant hypertension patients with significant reduction in office blood pressure (BP). This resulted in a growing enthusiasm in the field and a rapid evolution of technology with expanding procedural indications. However, the first randomised sham-controlled trial, Symplicity HTN-3, failed to demonstrate a significant difference in BP reduction between the RAD and the sham control arm, which subsequently led to a major reduction in the clinical application of this procedure. Additionally, the results generated further interest into understanding the mechanism and factors affecting procedural success and identifying the limitations within the field. Many lessons were learned from Symplicity HTN-3 trial, and with recent evidence emerging for RAD in hypertension treatment, the field continues to be refined.
早期的肾动脉去神经术（RAD）研究表明，该治疗方法对治疗耐药性高血压患者有效，可显著降低诊室血压（BP）。这在该领域引起了越来越多的关注，技术也迅速发展，手术适应证不断扩大。然而，第一项随机假手术对照试验 Symplicity HTN-3 未能证明 RAD 与假手术对照组之间在降压方面有显著差异，随后该手术的临床应用大大减少。此外，该结果进一步引发了人们对了解影响手术成功率的机制和因素的兴趣，并确定了该领域的局限性。Symplicity HTN-3 试验吸取了许多教训，随着最近 RAD 治疗高血压的证据不断涌现，该领域仍在不断完善。
