Document Detail

[Renal denervation for the treatment of resistant hypertension: definition, patient selection and description of the procedure. 2012 Position paper of the Italian Society of Hypertension].
MedLine Citation:
PMID:  23196688     Owner:  NLM     Status:  In-Data-Review    
Hypertension is responsible for a relevant burden of cardiovascular morbidity and mortality worldwide. Although several appropriate and integrated pharmacological strategies are available, blood pressure control still remains largely unsatisfactory. Failure to achieve effective blood pressure control in treated hypertensive patients may have a substantial impact on overall cardiovascular risk, since it significantly increases the risk of both macrovascular and microvascular complications. Hypertension is arbitrarily defined as "resistant" or "refractory" when recommended blood pressure goals (clinic blood pressure <140/90 mmHg, or <130/80 mmHg in patients with type 2 diabetes mellitus) are not achieved, despite changes in lifestyle and treatment with adequate doses of at least three antihypertensive drugs from different classes, including a diuretic. A new non-pharmacological option for the treatment of patients with resistant hypertension has recently become available. Renal sympathetic denervation is a minimally invasive procedure performed via femoral access that uses radiofrequency catheter ablation to disable renal sympathetic afferent and efferent nerves. It results in isolation of renal parenchymal and juxtaglomerular cells from the abnormal enhancement of renal adrenergic nerve activity. The present position paper of the Italian Society of Hypertension provides a diagnostic and therapeutic approach to the early identification and effective clinical management of patients with resistant hypertension, who may be candidates for renal denervation. These indications may have important implications not only from a clinical viewpoint but also from an economic perspective. The accurate identification of patients with resistant hypertension and the appropriate selection of patients eligible for this procedure may help improve blood pressure control and reduce the risk of cardiovascular and cerebrovascular complications in these patients.
Massimo Volpe; Enrico Agabiti-Rosei; Ettore Ambrosioni; Santina Cottone; Cesare Cuspidi; Claudio Borghi; Nicola De Luca; Francesco Fallo; Claudio Ferri; Giuseppe Mancia; Alberto Morganti; Maria Lorenza Muiesan; Riccardo Sarzani; Leonardo Sechi; Giuliano Tocci; Agostino Virdis
Publication Detail:
Type:  English Abstract; Journal Article    
Journal Detail:
Title:  Giornale italiano di cardiologia (2006)     Volume:  13     ISSN:  1827-6806     ISO Abbreviation:  G Ital Cardiol (Rome)     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101263411     Medline TA:  G Ital Cardiol (Rome)     Country:  Italy    
Other Details:
Languages:  ita     Pagination:  846-52     Citation Subset:  IM    
Vernacular Title:
Denervazione delle arterie renali nel trattamento dell'ipertensione arteriosa resistente: definizione della patologia, selezione dei pazienti e descrizione della procedura. Documento di Indirizzo 2012 della Società Italiana dell'Ipertensione Arteriosa (SIIA).
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