Renal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure.

Santina Cottone, Leonardo Sechi, Giuseppe Mancia, Riccardo Sarzani, Giuliano Tocci, Maria Lorenza Muiesan, Cesare Cuspidi, Agostino Virdis, Francesco Fallo, Nicola De Luca, Alberto Morganti, Massimo Volpe, Ettore Ambrosioni, Claudio Borghi, Enrico Agabiti Rosei, Claudio Ferri

Risultato della ricerca: Article

17 Citazioni (Scopus)

Abstract

Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. Arterial hypertension is arbitrarily defined as 'resistant' or 'refractory' when the recommended blood pressure goals (clinic blood pressure below 140/90 mmHg or below 130/80 mmHg in patients with type 2 diabetes mellitus or nephropathy) are not achieved in the presence of a therapeutic strategy that includes lifestyle changes and at least three classes of antihypertensive drugs, including a diuretic, at adequate doses. Recently, an innovative non-pharmacological option has become available for treating resistant hypertension. Sympathetic denervation of renal arteries is a minimally invasive procedure that is performed via percutaneous access from the femoral artery. It consists of radiofrequency ablation of the afferent and efferent nerves of the renal sympathetic nervous system, with consequent isolation of renal parenchymal and juxtaglomerular structures from abnormal stimulation of the efferent adrenergic system. The present position paper of the Italian Society of Hypertension (SIIA) offers a diagnostic and therapeutic approach for the proper identification and effective clinical management of patients with resistant hypertension, who are candidates for renal artery denervation. These indications may have important implications not only from a clinical point of view, but also from an economic point of view, since a proper identification of patients with true resistant hypertension and an accurate selection of patients suitable for the procedure of renal denervation can contribute to an improved control of blood pressure, and thus a reduced risk of cardiovascular and cerebrovascular complications in these patients.
Lingua originaleEnglish
pagine (da-a)237-244
Numero di pagine8
RivistaHIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION
Volume4
Stato di pubblicazionePublished - 2013

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Denervation
Renal Artery
Patient Selection
Hypertension
Blood Pressure
Kidney
Sympathectomy
Sympathetic Nervous System
Femoral Artery
Diuretics
Adrenergic Agents
Type 2 Diabetes Mellitus
Antihypertensive Agents
Life Style
Economics
Pharmacology
Morbidity
Mortality
Therapeutics

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cita questo

Renal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure. / Cottone, Santina; Sechi, Leonardo; Mancia, Giuseppe; Sarzani, Riccardo; Tocci, Giuliano; Muiesan, Maria Lorenza; Cuspidi, Cesare; Virdis, Agostino; Fallo, Francesco; De Luca, Nicola; Morganti, Alberto; Volpe, Massimo; Ambrosioni, Ettore; Borghi, Claudio; Agabiti Rosei, Enrico; Ferri, Claudio.

In: HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION, Vol. 4, 2013, pag. 237-244.

Risultato della ricerca: Article

Cottone, S, Sechi, L, Mancia, G, Sarzani, R, Tocci, G, Muiesan, ML, Cuspidi, C, Virdis, A, Fallo, F, De Luca, N, Morganti, A, Volpe, M, Ambrosioni, E, Borghi, C, Agabiti Rosei, E & Ferri, C 2013, 'Renal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure.', HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION, vol. 4, pagg. 237-244.
Cottone, Santina ; Sechi, Leonardo ; Mancia, Giuseppe ; Sarzani, Riccardo ; Tocci, Giuliano ; Muiesan, Maria Lorenza ; Cuspidi, Cesare ; Virdis, Agostino ; Fallo, Francesco ; De Luca, Nicola ; Morganti, Alberto ; Volpe, Massimo ; Ambrosioni, Ettore ; Borghi, Claudio ; Agabiti Rosei, Enrico ; Ferri, Claudio. / Renal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure. In: HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION. 2013 ; Vol. 4. pagg. 237-244.
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abstract = "Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. Arterial hypertension is arbitrarily defined as 'resistant' or 'refractory' when the recommended blood pressure goals (clinic blood pressure below 140/90 mmHg or below 130/80 mmHg in patients with type 2 diabetes mellitus or nephropathy) are not achieved in the presence of a therapeutic strategy that includes lifestyle changes and at least three classes of antihypertensive drugs, including a diuretic, at adequate doses. Recently, an innovative non-pharmacological option has become available for treating resistant hypertension. Sympathetic denervation of renal arteries is a minimally invasive procedure that is performed via percutaneous access from the femoral artery. It consists of radiofrequency ablation of the afferent and efferent nerves of the renal sympathetic nervous system, with consequent isolation of renal parenchymal and juxtaglomerular structures from abnormal stimulation of the efferent adrenergic system. The present position paper of the Italian Society of Hypertension (SIIA) offers a diagnostic and therapeutic approach for the proper identification and effective clinical management of patients with resistant hypertension, who are candidates for renal artery denervation. These indications may have important implications not only from a clinical point of view, but also from an economic point of view, since a proper identification of patients with true resistant hypertension and an accurate selection of patients suitable for the procedure of renal denervation can contribute to an improved control of blood pressure, and thus a reduced risk of cardiovascular and cerebrovascular complications in these patients.",
author = "Santina Cottone and Leonardo Sechi and Giuseppe Mancia and Riccardo Sarzani and Giuliano Tocci and Muiesan, {Maria Lorenza} and Cesare Cuspidi and Agostino Virdis and Francesco Fallo and {De Luca}, Nicola and Alberto Morganti and Massimo Volpe and Ettore Ambrosioni and Claudio Borghi and {Agabiti Rosei}, Enrico and Claudio Ferri",
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T1 - Renal artery denervation for treating resistant hypertension : definition of the disease, patient selection and description of the procedure.

AU - Cottone, Santina

AU - Sechi, Leonardo

AU - Mancia, Giuseppe

AU - Sarzani, Riccardo

AU - Tocci, Giuliano

AU - Muiesan, Maria Lorenza

AU - Cuspidi, Cesare

AU - Virdis, Agostino

AU - Fallo, Francesco

AU - De Luca, Nicola

AU - Morganti, Alberto

AU - Volpe, Massimo

AU - Ambrosioni, Ettore

AU - Borghi, Claudio

AU - Agabiti Rosei, Enrico

AU - Ferri, Claudio

PY - 2013

Y1 - 2013

N2 - Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. Arterial hypertension is arbitrarily defined as 'resistant' or 'refractory' when the recommended blood pressure goals (clinic blood pressure below 140/90 mmHg or below 130/80 mmHg in patients with type 2 diabetes mellitus or nephropathy) are not achieved in the presence of a therapeutic strategy that includes lifestyle changes and at least three classes of antihypertensive drugs, including a diuretic, at adequate doses. Recently, an innovative non-pharmacological option has become available for treating resistant hypertension. Sympathetic denervation of renal arteries is a minimally invasive procedure that is performed via percutaneous access from the femoral artery. It consists of radiofrequency ablation of the afferent and efferent nerves of the renal sympathetic nervous system, with consequent isolation of renal parenchymal and juxtaglomerular structures from abnormal stimulation of the efferent adrenergic system. The present position paper of the Italian Society of Hypertension (SIIA) offers a diagnostic and therapeutic approach for the proper identification and effective clinical management of patients with resistant hypertension, who are candidates for renal artery denervation. These indications may have important implications not only from a clinical point of view, but also from an economic point of view, since a proper identification of patients with true resistant hypertension and an accurate selection of patients suitable for the procedure of renal denervation can contribute to an improved control of blood pressure, and thus a reduced risk of cardiovascular and cerebrovascular complications in these patients.

AB - Arterial hypertension is responsible for a significant burden of cardiovascular morbidity and mortality, worldwide. Although several rational and integrated pharmacological strategies are available, the control of high blood pressure still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on individual global cardiovascular risk, since it significantly increases the risk of developing hypertension-related macrovascular and microvascular complications. Arterial hypertension is arbitrarily defined as 'resistant' or 'refractory' when the recommended blood pressure goals (clinic blood pressure below 140/90 mmHg or below 130/80 mmHg in patients with type 2 diabetes mellitus or nephropathy) are not achieved in the presence of a therapeutic strategy that includes lifestyle changes and at least three classes of antihypertensive drugs, including a diuretic, at adequate doses. Recently, an innovative non-pharmacological option has become available for treating resistant hypertension. Sympathetic denervation of renal arteries is a minimally invasive procedure that is performed via percutaneous access from the femoral artery. It consists of radiofrequency ablation of the afferent and efferent nerves of the renal sympathetic nervous system, with consequent isolation of renal parenchymal and juxtaglomerular structures from abnormal stimulation of the efferent adrenergic system. The present position paper of the Italian Society of Hypertension (SIIA) offers a diagnostic and therapeutic approach for the proper identification and effective clinical management of patients with resistant hypertension, who are candidates for renal artery denervation. These indications may have important implications not only from a clinical point of view, but also from an economic point of view, since a proper identification of patients with true resistant hypertension and an accurate selection of patients suitable for the procedure of renal denervation can contribute to an improved control of blood pressure, and thus a reduced risk of cardiovascular and cerebrovascular complications in these patients.

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M3 - Article

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EP - 244

JO - HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION

JF - HIGH BLOOD PRESSURE & CARDIOVASCULAR PREVENTION

SN - 1120-9879

ER -