treatment of resistant hypertension with renal denervation – yes or no?

The true resistant hypertension is rare. The reasons are not entirely clear, but undoubtedly vegetative nervous system (renal afferent and efferent nerves) plays an important role. Surgical sympathectomy is effective but because of serious side effects is inappropriate. In recent years, a special catheter for endovascular renal radiofrequent denervation has been developed. With this method we have treated in accordance with the Slovenian and European recommendations, five patients with resistant hypertension. The radiofrequent ablation of renal arteries was not effective in our patients which is not what we expected because of  the results of the first two non-randomized uncontrolled studies - Simplicity HTN 1 and 2. The third in a series of international multicentre studies - a randomized, controlled, single-blind study Simplicity HTN 3 showed, however, that renal denervation is not effective method for the treatment of resistant hypertension. A detailed overview of enrolled patients suggests that certain patients may be eligible for intervention, but have not yet been identified.