Renal Denervation Returns: Reading a Second Generation of Sham-Controlled Trials in Resistant Hypertension
DOI:
https://doi.org/10.5281/zenodo.22386453Abstract
Catheter-based renal denervation ablates sympathetic nerve fibres running along the renal artery wall, and had been
expected to become a routine third option for resistant hypertension until the sham-controlled Symplicity HTN-3 trial
found no significant benefit over sham in 2014. Rather than ending the field, that failure forced a redesign: newer catheters
with confirmed circumferential ablation, pre-specified drug-adherence testing, and rigorous sham-procedure control.
A second generation of trials built on this redesign has now reported, and its results are more interesting, and more
genuinely uncertain, than either a simple vindication or a simple repeat failure.
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