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In this prospective, single-arm pilot study, patients with systolic office BP\u2009\u2265\u2009140\u00a0mmHg and mean 24-h systolic ambulatory blood pressure (ABP)\u2009\u2265\u2009130\u00a0mmHg despite being on a minimum of 3 antihypertensive drugs underwent radiofrequency RDN. The primary efficacy outcome was the temporal evolution of mean 24-h systolic ABP throughout 5\u00a0years post RDN. Effect modification of the primary outcome was studied for baseline magnetic resonance pulse wave velocity (MR-PWV), MR aortic distensibility (MR-AoD), ultrasound carotid femoral pulse wave velocity (CF-PWV) and clinical parameters. Analyses were performed using linear mixed-effects models to account for repeated BP measurements. A total of 30 patients were enrolled, 50% were female, mean age was 62.5\u2009\u00b1\u200910.7\u00a0years. Baseline mean 24-h ABP was 146.7\/80.8\u2009\u00b1\u200913.7\/12.0 despite a median of 5.0\u2009\u00b1\u20092.4 defined daily doses (DDD) of antihypertensive drugs. Baseline median MR-PWV was 6.8 [25th\u201375th percentile: 6.1\u201311.0] m\/s, median MR-AoD was 1.4\u2009\u00d7\u200910\n                    <jats:sup>\u20133<\/jats:sup>\n                    \u00a0mmHg\n                    <jats:sup>\u22121<\/jats:sup>\n                    [25th\u201375th percentile: 0.9\u20131.8] and mean CF-PWV was 8.5\u2009\u00b1\u20092.1\u00a0m\/s. Throughout 5\u00a0years following RDN, the change in mean 24-h systolic ABP was \u2212\u200911.5 [95% CI \u2212\u200917.0, \u2212\u20095.9] mmHg (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009&lt;0.001). MR-PWV emerged as the sole significant independent effect modifier of the change in mean 24-h systolic ABP throughout 5\u00a0years following RDN (+\u20091.8 [95% CI 0.7, 2.8] mmHg per m\/s per 5\u00a0years;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). A higher level of preprocedural arterial stiffness, as measured using MR-PWV, was associated with a smaller BP lowering effect 5\u00a0years post-RDN.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Graphical abstract<\/jats:bold>\n                  <\/jats:p>","DOI":"10.1007\/s12928-025-01191-w","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T11:20:58Z","timestamp":1758626458000},"page":"100-111","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between arterial stiffness and long-term efficacy of renal sympathetic denervation: 5-year results of the ASORAS study"],"prefix":"10.1007","volume":"41","author":[{"given":"Kari A.","family":"Saville","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor J. 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J Hypertens. 2023;41(3):516\u20139.","journal-title":"J Hypertens"}],"container-title":["Cardiovascular Intervention and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12928-025-01191-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12928-025-01191-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12928-025-01191-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T15:23:30Z","timestamp":1767885810000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12928-025-01191-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["1191"],"URL":"https:\/\/doi.org\/10.1007\/s12928-025-01191-w","relation":{},"ISSN":["1868-4300","1868-4297"],"issn-type":[{"value":"1868-4300","type":"print"},{"value":"1868-4297","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,23]]},"assertion":[{"value":"2 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Alexander Hirsch received a research grant and consultancy fees from GE Healthcare and speaker fees from GE Healthcare, Bayer, and Bristol Myers Squibb. He is also a member of the medical advisory board of Medis Medical Imaging Systems and was MRI corelab supervisor of Cardialysis BV until 2022. Nicolas M. Van Mieghem has received grant support\/research contracts from Abbott Vascular, Boston Scientific, Medtronic, Edwards Life-sciences, Daiichi Sankyo, Astra Zeneca and PulseCath BV and has received consulting\/speaker fees from Abbot Vascular, Boston Scientific Corporation, Medtronic, Daiichi Sankyo, PulseCath BV, JenaValve, and Amgen. Joost Daemen received institutional grant\/research support from Abbott Vascular, Boston Scientific, ACIST Medical, Medtronic, Pie Medical, and ReCor medical, and consultancy and speaker fees from Abbott Vascular, Abiomed, ACIST medical, Boston Scientific, Cardialysis BV, CardiacBooster, Kaminari Medical, ReCor Medical, PulseCath, Pie Medical, Sanofi, Siemens Health Care and Medtronic. All other authors declare no relevant interests to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}