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Substantial blood pressure reduction with renal denervation in a drug-naïve patient intolerant to antihypertensive pharmacotherapy: a case report

Journal of Human Hypertension volume 28, pages 517–518 (2014)Cite this article

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Although the importance of controlling blood pressure to reduce cardiovascular risk is well recognized, <50% of hypertensive patients actually attain blood pressure goals.1 Physician inertia, non-compliance and non-adherence with prescribed medication and intolerance of drugs owing to side effects have been identified as important contributors. Newly prescribed antihypertensive drugs are changed or discontinued by 20–50% of patients within the first 6–12 months after initiation according to studies from the UK,2, 3 Europe4 and the USA.5 Intolerance to multiple antihypertensive medications was attributed to treatment resistance in ∼14% of resistant hypertensive patients.6 Alternative approaches to improve blood pressure control are needed. In this context, recent studies have demonstrated the safety and efficacy of trans-catheter renal nerve ablation in patients with resistant hypertension on at least three antihypertensive drugs. Here we report on a drug-naïve patient with intolerance of antihypertensive pharmacotherapy and uncontrolled blood pressure who underwent bilateral renal denervation.

In the absence of alternative options for the treatment of her uncontrolled hypertension, she was offered to undergo trans-catheter radiofrequency ablation of her renal arteries. The procedure was uncomplicated and the patient was treated with seven ablations on each renal artery using the Symplicity catheter system (Medtronic, Minneapolis, MN, USA). Angiographic assessment post procedure did not reveal any vascular compromise and renal function was unchanged at follow-up.

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Author notes

  1. M P Schlaich: This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

Authors and Affiliations

  1. Neurovascular Hypertension & Kidney Disease Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia

    J Xu, D Hering, Y Sata & M P Schlaich

  2. Heart Centre, Alfred Hospital, Melbourne, Victoria, Australia

    A Walton & M P Schlaich

  3. Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia

    M P Schlaich

Authors
  1. J Xu
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  2. A Walton
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  3. D Hering
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  4. Y Sata
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  5. M P Schlaich
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Correspondence to M P Schlaich.

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Competing interests

Dr Schlaich and Dr Walton have received research and travel support, and speaker fees from Medtronic.

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Xu, J., Walton, A., Hering, D. et al. Substantial blood pressure reduction with renal denervation in a drug-naïve patient intolerant to antihypertensive pharmacotherapy: a case report. J Hum Hypertens 28, 517–518 (2014). https://doi.org/10.1038/jhh.2013.113

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