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Novel approaches to the treatment of patients with resistant hypertension: renal sympathetic denervation

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dc.contributor.author Moiseeva, Anna
dc.date.accessioned 2019-06-24T22:33:02Z
dc.date.available 2019-06-24T22:33:02Z
dc.date.issued 2016
dc.identifier.citation MOISEEVA, Anna. Novel approaches to the treatment of patients with resistant hypertension: renal sympathetic denervation. In: Curierul Medical. 2016, vol. 59, no 4, pp. 33-37. ISSN 1875-0666.
dc.identifier.issn 1857-0666
dc.identifier.uri http://moldmedjournal.md/wp-content/uploads/2016/09/Cm-4-2016-PDF.pdf
dc.identifier.uri http://repository.usmf.md/handle/20.500.12710/2934
dc.description.abstract Background: Hypertension continues to be a major burden of public health concern despite the recent advances and proven benefit of pharmacological therapy. A certain subset of patients has hypertension resistant to maximal medical therapy and appropriate lifestyle measures. Resistant hypertension continues to pose a major challenge to clinicians worldwide and has serious implications for patients who are at increased risk of cardiovascular morbidity and mortality with this diagnosis. Pharmacological therapy for resistant hypertension follows guidelines-based regimens, although there is surprisingly scant evidence for beneficial outcomes using additional drug treatment after three antihypertensives have failed to achieve target blood pressure. Through modulation of renin secretion, glomerular filtration rate and renal absorption of sodium, the sympathetic innervation of the kidneys plays an important role in the pathogenesis of hypertension. A novel catheter-based technique for renal sympathetic denervation (RSDN) as a new therapeutic avenue has great promise for the treatment of resistant hypertension. Renal denervation has the unique advantage of offering the denervation at the renal level, thus mitigating the systemic side effects. Various trials evaluated the role of renal denervation in the management of resistant hypertension and have found promising results. More studies are underway to evaluate the role of renal denervation in patients presenting with resistant hypertension in different scenarios.  Conclusions: This review included the physiology of the renal sympathetic nervous system and the renal nerve anatomy. Furthermore, the RSDN procedure, technology systems, and RSDN clinical trials as well as findings besides antihypertensive effects were discussed. Findings on safety and efficacy seem to suggest that renal sympathetic denervation could be of therapeutic benefit in refractory hypertensive patients. Despite the fast pace of development in RSDN therapies, only initial and very limited clinical data are available. Large gaps in knowledge concerning the long-term effects and consequences of RSDN still exist, and solid, randomized data are warranted. en_US
dc.language.iso en en_US
dc.publisher Ministerul Sănătăţii al Republicii Moldova, Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu” en_US
dc.relation.ispartof Curierul Medical
dc.subject renal sympathetic denervation en_US
dc.subject resistant hypertension en_US
dc.subject.mesh Hypertension--therapy en_US
dc.subject.mesh Kidney--innervation en_US
dc.subject.mesh Sympathectomy en_US
dc.subject.mesh Sympathetic Nervous System en_US
dc.title Novel approaches to the treatment of patients with resistant hypertension: renal sympathetic denervation en_US
dc.type Article en_US


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