Die renale Denervation als Therapiestrategie der medikamentös refraktären arteriellen Hypertonie

Arterial hypertension is a major health problem and the leading cause of death worldwide. Only half of all treated hypertensives are controlled to established blood pressure targets. The contribution of renal sympathetic nerve activity to the development and progression of hypertension has been demonstrated. New selective, catheter-based renal denervation shows a very promising non-invasive procedure for the treatment of resistant arterial hypertension. The renal sympathetic denervation treatment uses low-power radiofrequency energy to deactivate the renal nerves, thereby selectively reducing both the pathologic central sympathetic drive to the kidney and the renal contribution to central sympathetic hyperactivity. The catheter-based intervention achieved a durable, clinically important reduction in blood pressure in patients with multi-drug resistant hypertension. This effect has been sustained through at least 24 months without decline in renal function.