The DENERHTN Randomized Controlled Trial: Renal Denervation for Resistant Hypertension Revisited

Despite large reductions in blood pressure seen in early studies of renal denervation, the SYMPLICITY HTN-3 randomized trial failed to show a reduction in systolic blood pressure with renal denervation when compared to medical therapy alone. As a result, interest in renal denervation as a treatment for resistant hypertension has waned. In the DENERHTN trial, Azizi and colleagues assessed the incremental benefit of adding renal denervation to standardized stepped-care antihypertensive treatment (SSAHT) for patients with resistant hypertension in an open-label, randomized-controlled trial with blinded endpoint evaluation. After four weeks of a standardized anti-hypertensive regimen to confirm resistant hypertension, patients were randomized to renal denervation in addition to SSAHT versus SSAHT alone. The primary endpoint was the mean change in daytime systolic blood pressure after six months as assessed by ambulatory monitoring. Of the 106 patients randomized (53 in each group), 101 had endpoints available for final analysis (48 in the intervention group and 53 in the control group). At six months, patients receiving renal denervation had a …