{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:51:51Z","timestamp":1792713111241,"version":"4.5.0"},"reference-count":78,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypertension represents the leading risk factor for death globally, affecting one in two adults. Despite dozens of inexpensive medications and lifestyle changes that effectively lower blood pressure (BP), hypertension control rates remain poor. Renal denervation (RDN) is a procedural therapy indicated as an adjunctive treatment for high BP. FDA approval in late 2023 followed the publication of a series of rigorous, second-generation, randomized clinical trials that demonstrated safety and efficacy of the procedure. Two catheters employing radiofrequency (Spyral) and ultrasound (Paradise) are currently approved to ablate renal sympathetic nerves. In randomized sham-controlled trials, RDN lowered BP in patients with mild-to-moderate and true resistant hypertension, and in patients both on and off antihypertensive medication. When evaluating patients for RDN, shared decision-making is a critical element, which should include potential benefits and that a minority may not respond to the therapy. There is only one constant predictor of magnitude of response: magnitude of baseline SBP, which is one reason why guidelines recommend prioritization of patients with resistant hypertension, together with patients whose BP cannot be effectively managed with medication. Before referring patients to a trained interventionalist, it is important to optimize medical therapy and adherence, and confirm uncontrolled hypertension out-of-office. Patients should be screened for primary aldosteronism and for other secondary causes of hypertension if clinically indicated, though sleep apnea is not a contraindication to RDN. A team approach is advised, with hypertension specialists and interventionalists collaborating. Data from global registries will augment our knowledge and guide future implementation.<\/jats:p>","DOI":"10.1093\/ajh\/hpaf134","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T08:21:01Z","timestamp":1753345261000},"page":"355-364","source":"Crossref","is-referenced-by-count":11,"title":["Renal Denervation to Treat Hypertension: A Clinical State-of-the-Art Review"],"prefix":"10.1093","volume":"39","author":[{"given":"Andrew S P","family":"Sharp","sequence":"first","affiliation":[{"name":"School of Medicine, University College Dublin , Dublin ,","place":["Ireland"]},{"name":"Department of Cardiology, Mater Misericordiae University Hospital , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1649-1441","authenticated-orcid":false,"given":"Naomi D L","family":"Fisher","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Hypertension, Brigham and Women\u2019s Hospital , Boston, Massachusetts ,","place":["USA"]},{"name":"Department of Medicine, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"2026021616021924900_CIT0001","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Collaborators GBDRF","year":"2020","journal-title":"Lancet"},{"key":"2026021616021924900_CIT0002","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0140-6736(21)01330-1","article-title":"Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants","volume":"398","author":"Collaboration NCDRF","year":"2021","journal-title":"Lancet"},{"key":"2026021616021924900_CIT0003","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1136\/bmj.39553.670231.25","article-title":"Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories","volume":"336","author":"Vrijens","year":"2008","journal-title":"BMJ"},{"key":"2026021616021924900_CIT0004","doi-asserted-by":"crossref","first-page":"e5641","DOI":"10.1097\/MD.0000000000005641","article-title":"Nonadherence to antihypertensive drugs: a systematic review and meta-analysis","volume":"96","author":"Abegaz","year":"2017","journal-title":"Medicine (Baltim)"},{"key":"2026021616021924900_CIT0005","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1097\/HJH.0000000000002783","article-title":"Therapeutic inertia in the management of hypertension in primary care","volume":"39","author":"Ali","year":"2021","journal-title":"J Hypertens"},{"key":"2026021616021924900_CIT0006","doi-asserted-by":"crossref","first-page":"e0248471","DOI":"10.1371\/journal.pone.0248471","article-title":"Antihypertensive treatment in a general uncontrolled hypertensive population in Belgium and Luxembourg in primary care: Therapeutic inertia and treatment simplification. 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