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Cited by 29Blood Pressure and Hypertension StudiesRenal and Vascular PathologiesCardiovascular Health and Disease Prevention

Renal denervation in the management of hypertension in adults. A clinical consensus statement of the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

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Barbato, Emanuele, Azizi, Michel, Schmieder, Roland E., Lauder, Lucas, Böhm, Michael, Brouwers, Sofie, Bruno, Rosa Maria, Dudek, Dariusz +13 more·2023·EuroIntervention
DOI 10.4244/eij-d-22-00723PMC PMC10020821
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Abstract

Since the publication of the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) Guidelines for the Management of Arterial Hypertension, several high-quality studies, including randomised, sham-controlled trials on catheter-based renal denervation (RDN) were published, confirming both the blood pressure (BP)-lowering efficacy and safety of radiofrequency and ultrasound RDN in a broad range of patients with hypertension, including resistant hypertension. A clinical consensus document by the ESC Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on RDN in the management of hypertension was considered necessary to inform clinical practice. This expert group proposes that RDN is an adjunct treatment option in uncontrolled resistant hypertension, confirmed by ambulatory BP measurements, despite best efforts at lifestyle and pharmacological interventions. RDN may also be used in patients who are unable to tolerate antihypertensive medications in the long term. A shared decision-making process is a key feature and preferably includes a patient who is well informed on the benefits and limitations of the procedure. The decision-making process should take (i) the patient's global cardiovascular (CV) risk and/or (ii) the presence of hypertension-mediated organ damage or CV complications into account. Multidisciplinary hypertension teams involving hypertension experts and interventionalists evaluate the indication and facilitate the RDN procedure. Interventionalists require expertise in renal interventions and specific training in RDN procedures. Centres performing these procedures require the skills and resources to deal with potential complications. Future research is needed to address open questions and investigate the impact of BP-lowering with RDN on clinical outcomes and potential clinical indications beyond hypertension.

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  • In 2023, clinical adoption of renal denervation was recommended by guidelines from the International Society of Hypertension and the European Renal Association, and from the European Society of Cardiology Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions.

    “clinical adoption of RDN was recommended in 2023 guidelines from the International Society of Hypertension and the European Renal Association15, and from the European Society of Cardiology Council on Hypertension and the European Association of Percutaneous Cardiovascular Interventions16,17”

    From Renal nerves in physiology, pathophysiology and interoception (2025) · cites this paper as [17]

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Cited by

Sorted by citations

Authors
Barbato, E., Azizi, M., Schmieder, R. E., Lauder, L., Böhm, M., Brouwers, S., Bruno, R. M., Dudek, D., Kahan, T., Kandzari, D. E., Lüscher, T. F., Parati, G., Pathak, A., Ribichini, F. L., Schlaich, M. P., Sharp, A. S. P., Sudano, I., Volpe, M., Tsioufis, C., Wijns, W., & Mahfoud, F.
Affiliations
  • Sapienza University of Rome (IT)
  • Inserm (FR)
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • Universitätsklinikum des Saarlandes (DE)
  • Vrije Universiteit Brussel (BE)
  • Jagiellonian University (PL)
  • Danderyds sjukhus (SE)
  • Piedmont Atlanta Hospital (US)
  • King's College London (GB)
  • Princess Grace Hospital Centre (MC)
  • University of Verona (IT)
  • The University of Western Australia (AU)
  • University Hospital of Wales (GB)
  • University Hospital Zurich (CH)
  • Azienda Ospedaliera Sant'Andrea (IT)
  • National and Kapodistrian University of Athens (GR)
  • Ollscoil na Gaillimhe – University of Galway (IE)
ORCID
Venue
EuroIntervention
Publisher
Europa Digital & Publishing
Published
2023-03
Volume
18
Issue
15
Pages
1227-1243
ISSN
1774-024X (ISSN-L)
DOI
10.4244/eij-d-22-00723
PMC
PMC10020821
OpenAlex
W4320857859
Cited by
29
References
9
Citations by year
2026: 3 · 2025: 4 · 2024: 11 · 2023: 11
FWCI
5.71
Type
journal article
Language
en
Open access
Locations
  • EuroIntervention (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Funders
  • Amgen
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • Sanofi
  • Alnylam Pharmaceuticals
  • Université de Lorraine
  • Uniwersytet Jagielloński Collegium Medicum
  • ReCor Medical
  • Omron Healthcare
  • Imperial College London (H2020)
  • University of Galway
  • Deutsche Forschungsgemeinschaft
  • Institut National de la Santé et de la Recherche Médicale
  • Università degli Studi di Milano-Bicocca
  • Karolinska Institutet
  • Novo Nordisk
  • Sapienza Università di Roma
  • Vrije Universiteit Brussel
  • National and Kapodistrian University of Athens
  • Universität des Saarlandes
  • Deutsche Herzstiftung
  • Universität Zürich
  • Università degli Studi di Verona
  • Universitätsspital Zürich
  • Istituto Auxologico Italiano
  • Deutsche Gesellschaft für Kardiologie-Herz und Kreislaufforschung.
  • Servier
  • Idorsia Pharmaceuticals
  • MicroPort
  • Horizon 2020 Framework Programme
  • Menzies Centre for Australian Studies, King's College London, University of London
  • National Health and Medical Research Council
  • Daiichi Sankyo Europe
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
renal denervation, resistant hypertension, hypertension, radiofrequency ablation, ultrasound ablation, blood pressure reduction, shared decision-making, cardiovascular risk, hypertension-mediated organ damage
MeSH terms
Adult, Antihypertensive Agents, Blood Pressure, Denervation, Humans, Hypertension, Kidney, Renal Artery, Sympathectomy, Treatment Outcome

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