Review
Pharmacology & Pharmacy
Omar Azzam, Sayeh Heidari Nejad, Revathy Carnagarin, Janis M. Nolde, Marcio Galindo-Kiuchi, Markus P. Schlaich
Summary: Resistant hypertension is associated with high cardiovascular risk and current guideline-recommended therapy is not sufficient. Recent landmark trials have shown promising results for novel compounds targeting unaddressed pathophysiologic pathways and catheter-based renal denervation as an effective adjunct therapeutic approach.
BRITISH JOURNAL OF PHARMACOLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Emanuele Barbato, Michel Azizi, Roland E. Schmieder, Lucas Lauder, Michael Boehm, Sofie Brouwers, Rosa Maria Bruno, Dariusz Dudek, Thomas Kahan, David E. Kandzari, Thomas F. Luscher, Gianfranco Parati, Atul Pathak, Flavio L. Ribichini, Markus P. Schlaich, Andrew S. P. Sharp, Isabella Sudano, Massimo Volpe, Costas Tsioufis, William Wijns, Felix Mahfoud
Summary: Since the publication of the 2018 ESC/ESH Guidelines, high-quality studies have confirmed the efficacy and safety of RDN in patients with hypertension. The consensus document recommends RDN as an adjunct treatment for uncontrolled resistant hypertension and for patients who cannot tolerate antihypertensive medications. A shared decision-making process is crucial, taking into account the patient's overall cardiovascular risk and the presence of hypertension-mediated organ damage or complications. Multidisciplinary hypertension teams involving experts and interventionalists are needed to evaluate indications and perform RDN procedures. Future research should focus on clinical outcomes and potential indications beyond hypertension.
EUROPEAN HEART JOURNAL
(2023)
Article
Peripheral Vascular Disease
Gianni Sesa-ashton, Janis M. Nolde, Ida Muente, Revathy Carnagarin, Rebecca Lee, Vaughan G. Macefield, Tye Dawood, Yusuke Sata, Elisabeth A. Lambert, Gavin W. Lambert, Antony Walton, Marcio G. Kiuchi, Murray D. Esler, Markus P. Schlaich
Summary: Long-term follow-up studies on catheter-based renal denervation in patients with resistant hypertension show that the method can still effectively reduce blood pressure and decrease medication usage after nearly 9 years of follow-up, without any adverse effects on renal function.
Editorial Material
Cardiac & Cardiovascular Systems
Bo Liang, Yi Liang, Rui Li, Ning Gu
Summary: Renal denervation is emerging as a promising non-drug treatment for resistant hypertension, but there is still a lack of evaluation on its long-term blood pressure control effect. Further research is needed to address the limitations and compare the antihypertensive effects of different renal denervation systems.
CARDIOVASCULAR DIABETOLOGY
(2021)
Article
Biochemistry & Molecular Biology
Marta Kantauskaite, Oliver Vonend, Mina Yakoub, Philipp Heilmann, Andras Maifeld, Peter Minko, Lars Schimmoeller, Gerald Antoch, Dominik N. Mueller, Claudia Schmidt, Blanka Duvnjak, Ulf Zierhut, Sebastian A. Potthoff, Lars C. Rump, Johannes C. Fischer, Johannes Stegbauer
Summary: This study investigated the effect of renal denervation (RDN) on T-cell signatures in patients with resistant hypertension (RH). The results showed that patients with RH had higher levels of pro-inflammatory cytokines and certain T-cell populations. However, those who responded well to RDN had reduced levels of inflammation, while non-responders had increased levels of certain T-cells and inflammatory activity. Therefore, a detailed analysis of T-cells might be useful in selecting patients for RDN treatment.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Medicine, General & Internal
Anna Pisano, Luigi Francesco Iannone, Antonio Leo, Emilio Russo, Giuseppe Coppolino, Davide Bolignano
Summary: In patients with resistant hypertension, there is low quality evidence that renal denervation does not significantly impact major cardiovascular events and renal function. Moderate quality evidence suggests that it does not have a significant effect on blood pressure, with low quality evidence indicating an increase in bradycardia episodes. Future studies focusing on patient-centric outcomes, with longer follow-up periods, larger sample sizes, and standardized procedures, are required to determine the true utility of renal denervation in this patient population.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2021)
Article
Cardiac & Cardiovascular Systems
Felix Mahfoud, Michael J. Bloch, Michel Azizi, Yale Wang, Roland E. Schmieder, Melvin D. Lobo, Andrew S. P. Sharp, Joost Daemen, Jan Basile, Michael A. Weber, Andrea P. Scicli, Candace K. McClure, Ajay J. Kirtane
Summary: In the RADIANCE-HTN SOLO study, patients originally assigned to a sham procedure who crossed over to receive ultrasound RDN treatment showed significant reductions in blood pressure during long-term follow-up, with no major procedure-related adverse events.
Article
Cardiac & Cardiovascular Systems
Yu Sato, Andrew S. P. Sharp, Felix Mahfoud, Stefan Tunev, Ashley Forster, Matthew Ellis, Ana Gomez, Roma Dhingra, Jeremy Ullman, Markus Schlaich, David Lee, Julie Trudel, Douglas A. Hettrick, David E. Kandzari, Renu Virmani, Aloke V. Finn
Summary: The distribution of nerve tissue along the renal artery in normotensive pigs is similar to that in humans, validating the translational value of the porcine model for RF-RDN.
Review
Medicine, General & Internal
Sumeeyae Haribabu, Faisal Sharif, Haroon Zafar
Summary: Hypertension is a major risk factor for cardiovascular disease, affecting over 1.13 billion people worldwide. Renal denervation (RDN) is a potential treatment for resistant hypertension and other conditions, despite initial challenges in efficacy. Various RDN devices are being developed and show promise as alternative treatments.
IRISH JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Cardiac & Cardiovascular Systems
Michael Boehm, Konstantinos Tsioufis, David E. Kandzari, Kazuomi Kario, Michael A. Weber, Roland E. Schmieder, Raymond R. Townsend, Saarraaken Kulenthiran, Christian Ukena, Stuart Pocock, Sebastian Ewen, Joachim Weil, Martin Fahy, Felix Mahfoud
Summary: This analysis evaluated the impact of baseline heart rate on blood pressure reduction after renal denervation. The results showed a greater reduction in blood pressure at 3 months post renal denervation for patients with baseline heart rate >= 70 beats/min.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Medicine, General & Internal
Ge Luo, Jian-Jun Zhu, Ming Yao, Ke-Yue Xie
Summary: An 80-year-old woman with trigeminal neuralgia and a history of resistant hypertension for over 10 years underwent chemical renal sympathetic denervation, leading to satisfactory blood pressure control for 4 years without antihypertensive medication.
WORLD JOURNAL OF CLINICAL CASES
(2021)
Article
Peripheral Vascular Disease
Roland E. Schmieder, Felix Mahfoud, Giuseppe Mancia, Michael Azizi, Michael Boehm, Kyriakos Dimitriadis, Kazuomi Kario, Abraham A. Kroon, Melvin D. Lobo, Christian Ott, Atul Pathak, Alexandre Persu, Filippo Scalise, Markus Schlaich, Reinhold Kreutz, Costas Tsioufis
Summary: This paper presents updated recommendations based on new pivotal sham-controlled randomized clinical trials, demonstrating the efficacy and safety of endovascular device-based renal denervation for hypertension treatment. Meta-analyses show a significant reduction in blood pressure and a decreased incidence of cardiovascular events with this treatment option.
JOURNAL OF HYPERTENSION
(2021)
Review
Peripheral Vascular Disease
Kenichi Katsurada, Keisuke Shinohara, Jiro Aoki, Shinsuke Nanto, Kazuomi Kario
Summary: Renal nerves play a critical role in regulating blood pressure and fluid volume, with dysfunction implicated in cardiovascular diseases. Afferent renal sensory nerves project to the hypothalamus to modulate sympathetic outflow, while efferent renal sympathetic nerves affect renin secretion and vascular resistance. Studies on renal denervation show promise for treating hypertension and heart failure in both basic and clinical research settings.
HYPERTENSION RESEARCH
(2022)
Article
Cardiac & Cardiovascular Systems
Karl Fengler, Karl-Philipp Rommel, Wenzel Kriese, Karl-Patrik Kresoja, Stephan Blazek, Danilo Obradovic, Hans-Josef Feistritzer, Christian Lucke, Matthias Gutberlet, Steffen Desch, Holger Thiele, Philipp Lurz
Summary: This study aimed to assess the ability of invasive and non-invasive methods to predict the response of blood pressure to renal sympathetic denervation (RDN). The results showed that iPWV is an independent predictor for blood pressure response after RDN, and non-invasive methods can also predict blood pressure changes.
Review
Peripheral Vascular Disease
Kazuomi Kario, Douglas A. Hettrick, Aleksander Prejbisz, Andrzej Januszewicz
Summary: There is a bidirectional, causal relationship between obstructive sleep apnea (OSA) and hypertension, with hypoxia/hypercapnia-related sympathetic activation being the key mechanism. While continuous positive airway pressure is the gold standard therapy for OSA, its effects on blood pressure are modest. Antihypertensive agents targeting sympathetic pathways or the renin-angiotensin-aldosterone system may have potential in patients with comorbid hypertension and OSA.
Review
Cardiac & Cardiovascular Systems
Martin H. Strauss, Alistair S. Hall, Krzysztof Narkiewicz
Summary: Cardiovascular disease is the leading cause of mortality worldwide, with hypertension being one of the earliest risk factors. Combining beta-blockers and ACE inhibitors into a single pill has been shown to effectively control hypertension and improve cardiovascular outcomes.
CARDIOVASCULAR DRUGS AND THERAPY
(2023)
Article
Cardiac & Cardiovascular Systems
Roland E. Schmieder, Felix Mahfoud, Giuseppe Mancia, Krzysztof Narkiewicz, Luis Ruilope, David Hutton, Khoa Cao, Douglas A. Hettrick, Martin Fahy, Markus P. Schlaich, Michael Bohm, Jan B. Pietzsch
Summary: Renal denervation using radiofrequency has been found to lower blood pressure and reduce cardiovascular events in patients with uncontrolled hypertension. The magnitude of blood pressure reduction and associated risks of cardiovascular events vary among different high-risk subgroups. Model-based projections suggest that radiofrequency renal denervation provides significant clinical benefits for patients with uncontrolled hypertension.
EUROPEAN HEART JOURNAL-QUALITY OF CARE AND CLINICAL OUTCOMES
(2023)
Article
Physics, Multidisciplinary
Paolo Castiglioni, Giampiero Merati, Gianfranco Parati, Andrea Faini
Summary: This study aims to compare different entropy measures (DistEn, SampEn, and FuzzyEn) for assessing heart rate variability (HRV). The results show that DistEn mainly reflects cardiovascular complexity, while SampEn and FuzzyEn primarily measure HRV randomness. These methods also exhibit different performance in analyzing postural changes and spinal cord injuries.
Review
Cardiac & Cardiovascular Systems
Luis M. Ruilope, Alberto Ortiz, Alejandro Lucia, Blanca Miranda, Gloria Alvarez-Llamas, Maria G. Barderas, Massimo Volpe, Gema Ruiz-Hurtado, Bertram Pitt
Summary: Chronic kidney disease (CKD) is a leading cause of death that requires early detection for effective management. The current diagnostic criteria for CKD only identify advanced stages, leaving a 'blind spot' in detection where kidney injury is present but undetectable. Elevated urinary albumin-excretion rate can predict future cardiovascular events. Implementing opportunistic or systematic albuminuria screening and therapy has the potential to improve cardiorenal outcomes and mitigate the projected burden of CKD and cardiovascular diseases in the future.
EUROPEAN HEART JOURNAL
(2023)
Article
Peripheral Vascular Disease
Revathy Carnagarin, Janis M. Nolde, Jun Yang, Francine Z. Marques, Dean S. Picone, Gavin W. Lambert, Thomas Beaney, Neil R. Poulter, Aletta E. Schutte, Christopher M. Reid, Derrin Brockman, Markus P. Schlaich
Summary: The awareness, treatment, and control rates of hypertension in Australia are substantially lower than global and high-income country rates, indicating the need for collaborative efforts to improve the situation.
JOURNAL OF HYPERTENSION
(2023)
Article
Cardiac & Cardiovascular Systems
Nicola Riccardo Pugliese, Nicolo De Biase, Lavinia Del Punta, Alessio Balletti, Silvia Armenia, Simona Buralli, Alessandro Mengozzi, Stefano Taddei, Marco Metra, Matteo Pagnesi, Barry A. Borlaug, Bryan Williams, Stefano Masi
Summary: This study evaluated the role of hypertensive response to exercise (HRE) in heart failure and investigated the hemodynamic and prognostic factors associated with HRE. The results showed that systolic blood pressure and workload slope were significantly different in heart failure patients, and HRE was associated with adverse outcomes.
EUROPEAN JOURNAL OF HEART FAILURE
(2023)
Article
Peripheral Vascular Disease
Felix Mahfoud, Giuseppe Mancia, Roland E. Schmieder, Luis Ruilope, Krzysztof Narkiewicz, Markus Schlaich, Bryan Williams, Flavio Ribichini, Joachim Weil, Khaled Almerri, Faisal Sharif, Lucas Lauder, Marianne Wanten, Martin Fahy, Michael Boehm
Summary: This study investigated whether the number or type of antihypertensive medications were associated with increased long-term blood pressure reductions and cardiovascular outcomes following radiofrequency renal denervation (RDN) in hypertensive patients. The results showed that radiofrequency RDN reduced blood pressure safely through 36 months, regardless of the number and type of baseline antihypertensive medication classes.
Article
Peripheral Vascular Disease
Gianni Sesa-ashton, Janis M. Nolde, Ida Muente, Revathy Carnagarin, Rebecca Lee, Vaughan G. Macefield, Tye Dawood, Yusuke Sata, Elisabeth A. Lambert, Gavin W. Lambert, Antony Walton, Marcio G. Kiuchi, Murray D. Esler, Markus P. Schlaich
Summary: Long-term follow-up studies on catheter-based renal denervation in patients with resistant hypertension show that the method can still effectively reduce blood pressure and decrease medication usage after nearly 9 years of follow-up, without any adverse effects on renal function.
Article
Multidisciplinary Sciences
Lakshini Yasaswi Herat, Jennifer Rose Matthews, Moira Hibbs, Elizabeth Piroska Rakoczy, Markus Peter Schlaich, Vance Bruce Matthews
Summary: SGLTs are transport proteins that can be inhibited to improve glycemic control and provide cardiorenal benefits. Dual SGLT1/2 inhibitors, such as sotagliflozin, target both SGLT1 and 2 proteins.
Article
Peripheral Vascular Disease
Sonali R. Gnanenthiran, Vivekanand Jha, Abdul Salam, Emily Atkins, Clara K. Chow, Mark R. Nelson, Mike Rakotz, Markus P. Schlaich, Aletta E. Schutte, Tim Usherwood, Anthony Rodgers
Summary: In this study, we assessed whether pooled cardiovascular expertise could accurately predict the efficacy and tolerability of both a novel and an established treatment option. A survey was conducted to collect predictions of blood pressure at 12 weeks and 52 weeks for participants in a trial called QUARTET, which involved two different treatment groups.
JOURNAL OF HUMAN HYPERTENSION
(2023)
Meeting Abstract
Peripheral Vascular Disease
Dawid Jedrzejewski, Ewan McFarlane, Peter Lacy, Bryan Williams
JOURNAL OF HYPERTENSION
(2023)
Meeting Abstract
Peripheral Vascular Disease
Thomas MacLennal MacDonald, Isla Shelah Mackenzie, Amy Rogers, Neil R. Poulter, Bryan Williams, Morris J. Brown, David J. Webb, Ian Ford, David Rorie, Kerr Grieve, Fillippo Pigazzani, Peter M. Rothwell, Robin Young, Alex McConnachie, Chim C. Lang
JOURNAL OF HYPERTENSION
(2023)
Review
Biochemistry & Molecular Biology
Jennifer Matthews, Lakshini Herat, Markus P. Schlaich, Vance Matthews
Summary: Chronic Kidney Disease (CKD) and Cardiovascular Disease (CVD) can occur together as cardiorenal disease. Sodium-dependent glucose cotransporter 2 (SGLT2) inhibitors show promise in treating cardiorenal disease by improving various indicators through multiple mechanisms.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)