Consensus and inconsistency between different consensus documents on renal denervation worldwide:the way forward

作     者：Tzung-Dau Wang Tzung-Dau Wang

作者机构：Department of Internal MedicineCardiovascular Center and Divisions of Cardiology and Hospital MedicineNational Taiwan University Hospital and National Taiwan University College of MedicineTaipeiTaiwan 100225China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2022年第135卷第24期

页      面：2926-2937页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Consensus Hypertension Guideline Patient Renal Denervation 

摘      要：Given the unsatisfactory hypertension control rates and high rates of non-adherence to antihypertensive medications worldwide,device therapy which can safely provide durable blood pressure-lowering effects can fulfill the unmet need.A series of second-generation randomized sham-controlled renal denervation(RDN)trials have demonstrated the efficacy and safety of RDN in a wide range of hypertensive *** four representative consensus documents on RDN(from the Chinese Taiwan Hypertension Society and Taiwan Society of Cardiology[THS/TSOC 2019],Asia Renal Denervation Consortium 2019,European Society of Hypertension[ESH 2021],and Society for Cardiovascular Angiography&Intervention and National Kidney Foundation[SCAI/NKF 2021])consistently recommend RDN as an alternative or complementary treatment strategy for patients with uncontrolled *** addition,both documents from Asia further recommend that RDN can be considered as an initial treatment strategy for drug-naïve hypertensive *** is still inconsistency regarding whether ambulatory blood pressure monitoring should be used routinely both before and after RDN,and whether patients with a secondary cause of hypertension could be treated with RDN if their blood pressure remains uncontrolled after definitive treatment(treatment-resistant secondary hypertension).The THS/TSOC consensus provides acronyms to summarize key aspects of patient selection(RDNi2)and pre-RDN assessments(RAS).The ESH and SCAI/NKF documents recommend establishing structured pathways for clinical practice and issues regarding *** documents identify knowledge gaps in RDN,from identifying predictors of super-responders to demonstrating effects on cardiovascular *** gaps should be urgently filled to facilitate the wider application of this device therapy for patients with hypertension.