Catheter-based renal denervation in the treatment of arterial hypertension: An expert consensus statement on behalf of the French Society of Hypertension (SFHTA), French Society of Radiology (SFR), French Society of Interventional Cardiology (GACI), Frenc

Several high-quality, randomized, sham-controlled trials have provided evidence supporting the efficacy and safety of radiofrequency, ultrasound and alcohol catheter-based renal denervation (RDN) for reducing blood pressure (BP). A French clinical consensus document has therefore been developed to propose guidance for the appropriate use of RDN in the management of hypertension along with a dedicated care pathway and management strategy. The French experts group concluded that RDN can serve as an adjunct therapy for patients with confirmed uncontrolled, resistant essential hypertension despite treatment with≥3 antihypertensive drugs, including a long-acting calcium channel blocker, a renin-angiotensin system blocker and a thiazide/thiazide-like diuretic at maximally tolerated doses. Patients should have (1) an estimated glomerular filtration rate of≥40mL/min/1.73m2; (2) an eligible renal artery anatomy on pre-RDN scans and (3) exclusion of secondary forms of hypertension. Additional indications might be considered for patients with difficult-to-control hypertension. Any indication of RDN should be validated by multidisciplinary hypertension teams consisting of both hypertension specialists and endovascular interventionalists in European Society of Hypertension (ESH) Excellence Centres or ESH-BP clinics. Patients should be informed about the benefit/risk ratio of RDN. Expertise in renal artery interventions and training in RDN techniques are needed for endovascular interventionalists conducting RDN procedures while centres offering RDN should have the necessary resources to manage potential complications effectively. Lastly, all patients undergoing RDN should have their data collected in a nationwide French registry to facilitate monitoring and evaluation of RDN outcomes, contributing to ongoing research and quality improvement efforts.

Pathak A ，Boulestreau R ，Sapoval M ，Lantelme P ，Duly-Bouhanick B ，Benamer H ，Bejan-Angoulvant T ，Cremer A ，Amar L ，Delarche N ，Ormezzano O ，Sabouret P ，Silhol F ，Sosner P ，Lopez-Sublet M ，Cohen A ，Courand PY ，Azizi M ... -  《-》

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).

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.

Barbato E ，Azizi M ，Schmieder RE ，Lauder L ，Böhm M ，Brouwers S ，Bruno RM ，Dudek D ，Kahan T ，Kandzari DE ，Lüscher TF ，Parati G ，Pathak A ，Ribichini FL ，Schlaich MP ，Sharp ASP ，Sudano I ，Volpe M ，Tsioufis C ，Wijns W ，Mahfoud F ... -  《-》

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).

Barbato E ，Azizi M ，Schmieder RE ，Lauder L ，Böhm M ，Brouwers S ，Bruno RM ，Dudek D ，Kahan T ，Kandzari DE ，Lüscher TF ，Parati G ，Pathak A ，Ribichini FL ，Schlaich MP ，Sharp ASP ，Sudano I ，Volpe M ，Tsioufis C ，Wijns W ，Mahfoud F ... -  《-》

Renal Denervation in the Treatment of Resistant Hypertension and Difficult-to-Control Hypertension - Consensus Document of the Croatian Hypertension League - Croatian Society of Hypertension, Croatian Cardiac Society, Croatian Endovascular Initiative, Cro

Jelaković B ，Perkov D ，Barišić K ，Bukal N ，Gellineo L ，Jelaković A ，Josipović J ，Prkačin I ，Željković Vrkić T ，Živko M ，On the behalf of Task force for the Resistant Hypertension and Renal Denervation of the Croatian Hypertension League ... -  《-》

[Italian Society of Interventional Cardiology (GISE) and Italian Society of Arterial Hypertension (SIIA) Consensus document on the role of renal denervation in the management of the difficult to treat hypertension].

Stabile E ，Muiesan ML ，Ribichini FL ，Sangiorgi G ，Taddei S ，Versaci F ，Villari B ，Bacca A ，Benedetto D ，Fioretti V ，Liccardo G ，Laurenzano E ，Scappaticci M ，Saia F ，Tarantini G ，Grassi G ，Esposito G ... -  《-》