About: Renal Denervation after Symplicity HTN-3: An Update

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Renal Denervation after Symplicity HTN-3: An Update
Creator	Jin, Yu Jacobs, Lotte Kjeldsen, Sverre Persu, Alexandre Renkin, Jean Elmula, Fadl Fadl, Mohamed
Source	Medline; PMC
abstract	After three years of excessive confidence, overoptimistic expectations and performance of 15 to 20,000 renal denervation procedures in Europe, the failure of a single well-designed US trial—Symplicity HTN-3—to meet its primary efficacy endpoint has cast doubt on renal denervation as a whole. The use of a sound methodology, including randomisation and blinded endpoint assessment was enough to see the typical 25–30 mmHg systolic blood pressure decrease observed after renal denervation melt down to less than 3 mmHg, the rest being likely explained by Hawthorne and placebo effects, attenuation of white coat effect, regression to the mean and other physician and patient-related biases. The modest blood pressure benefit directly assignable to renal denervation should be balanced with unresolved safety issues, such as potentially increased risk of renal artery stenosis after the procedure (more than ten cases reported up to now, most of them in 2014), unclear long-term impact on renal function and lack of morbidity–mortality data. Accordingly, there is no doubt that renal denervation is not ready for clinical use. Still, renal denervation is supported by a strong rationale and is occasionally followed by major blood pressure responses in at-risk patients who may otherwise have remained uncontrolled. Upcoming research programmes should focus on identification of those few patients with truly resistant hypertension who may derive a substantial benefit from the technique, within the context of well-designed randomised trials and independent registries. While electrical stimulation of baroreceptors and other interventional treatments of hypertension are already “knocking at the door”, the premature and uncontrolled dissemination of renal denervation should remain an example of what should not be done, and trigger radical changes in evaluation processes of new devices by national and European health authorities.
has issue date	2014-06-10(xsd:dateTime)
bibo:doi	10.1007/s11906-014-0460-x
bibo:pmid	24913923
has license	no-cc
sha1sum (hex)	eae2836920703308785197c3ef49af9f10fcdb16
schema:url	https://doi.org/10.1007/s11906-014-0460-x
resource representing a document's title	Renal Denervation after Symplicity HTN-3: An Update
has PubMed Central identifier	PMC4122808
has PubMed identifier	24913923
schema:publication	Curr Hypertens Rep
resource representing a document's body	covid:eae2836920703308785197c3ef49af9f10fcdb16#body_text
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