renal sympathetic denervation for the treatment of difficult-to-control or resistant hypertension抑制肾交感神经切除治疗或抗高血压.pdf

SAGE-Hindawi Access to Research International Journal of Hypertension Volume 2011, Article ID 196518, 8 pages doi:10.4061/2011/196518 Review Article Renal Sympathetic Denervation for the Treatment of Difficult-to-Control or Resistant Hypertension Vasilios Papademetriou,1 Michalis Doumas,2 and Konstantinos Tsioufis3 1 Veterans Aff airs and Georgetown University Medical Centers, 50 Irving Street, Washington, DC 20422, USA 2 Aristotle University of Thessaloniki, Thessaloniki, Greece 3 National and Kapodistrian University of Athens, Athens, Greece Correspondence should be addressed to Vasilios Papademetriou, v.papademetriou@ Received 1 October 2010; Revised 22 December 2010; Accepted 19 January 2011 Academic Editor: Alan Gradman Copyright © 2011 Vasilios Papademetriou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Hypertension represents a major health problem with an appalling annual toll. Despite the plethora of antihypertensive drugs, hypertension remains resistant in a considerable number of patients, thus creating the need for alternative strategies, including interventional approaches. Recently, catheter-based renal sympathetic denervation has been shown to be fairly safe and effective in patients with resistant hypertension. Pathophysiology of kidney function, interaction and crosstalk between the kidney and the brain, justifies the use of renal sympathetic denervation in the treatment of hypertension. Data from older studies have shown that sympathectomy has effectively lowered blood pressure and prolonged life expectancy of hypertensive patients, but at considerable cost. Renal sympathe