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This paper focuses on two current critical concerns of renal denervation (RDN): appropriate patient selection and the improvement in the accuracy of selective RDN. A hopeful way of accurate RDN may be the combination of 3D electroanatomic mapping systems for the renal artery with modified renal nerve stimulation (RNS) techniques and technology for appropriate hypertensive candidates.
The chronic input from afferent renal nerves does not contribute to the development of hypertension in SHRSP despite the increased blood pressure response to the acute stimulation of afferent renal nerves. Efferent renal nerves may be involved in the development of hypertension via activation of the renin-angiotensin system in SHRSP.
Always-on” 24 h blood pressure (BP) lowering effect of renal denervation with sufficient reduction of nighttime and morning BP that is difficult to control even by office BP-guided intense titration of multiple antihypertensive drugs.
Heterogenous BP responses after RDN for resistant hypertension. The bar graph represents the difference in SBP at 6 months after RDN compared with the baseline SBP, for each patient (1A). Efficacy of the renal denervation procedure. Percentage of patients whose SBP decreased ≥10 mmHg from baseline or whose medication decreased from baseline (1B).
