{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T09:10:27Z","timestamp":1779354627739,"version":"3.51.4"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T00:00:00Z","timestamp":1764979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Over one-third of Canadians with hypertension do not achieve recommended blood pressure (BP) targets despite availability of effective treatments. Renal sympathetic nerve denervation (RDN) is a recently approved, minimally invasive treatment for hypertension being offered in multiple Canadian centers. How best to implement this procedure in contemporary Canadian clinical practice remains unclear. Herein, we provide a Canadian hypertension specialist viewpoint on use of RDN in Canada. We review the rationale for, and evidence supporting, the use of RDN and discuss, using 2 clinical cases, its potential therapeutic role. We note that RDN has effectively lowered BP in multiple, sham-controlled, randomized clinical trials and has a favorable safety profile. Economic models indicate that it is cost-effective in the Canadian context. Conversely, the BP-lowering effect is relatively modest; no well-established method to pre-identify responders exists; cardiovascular endpoint data supporting use of RDN are lacking; and no clear funding model is currently in place in Canada. Accordingly, we suggest that use of RDN be reserved for willing patients with severely elevated BP despite the use of first-line conventional therapies who have had secondary causes excluded. Examples include patients with resistant hypertension or moderate or severe hypertension and multiple drug intolerance syndrome. In view of its recent approval and known operator-dependency, RDN should be offered solely through programmatic, multidisciplinary collaboration between hypertension specialists and experienced interventionalists using a shared decision-making approach with the patient. Funding deployment should target such programs and sites should carefully monitor their outcomes to confirm comparability to the published literature.<\/jats:p>","DOI":"10.1093\/ajh\/hpaf236","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T13:29:08Z","timestamp":1764941348000},"page":"735-743","source":"Crossref","is-referenced-by-count":0,"title":["The Role of Renal Denervation in the Treatment of Hypertension in Canada: A Case-Based Discussion from the Canadian Hypertension Specialists Society"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3541-2817","authenticated-orcid":false,"given":"Raj S","family":"Padwal","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Alberta , Edmonton, AB,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Dorsch","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta , Edmonton, AB,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheldon","family":"Tobe","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre , Toronto, ON,","place":["Canada"]},{"name":"Department of Medicine, Northern Ontario School of Medicine , ON, Thunder Bay, Ontario,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Ringrose","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta , Edmonton, AB,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4502-2823","authenticated-orcid":false,"given":"Ernesto L","family":"Schiffrin","sequence":"additional","affiliation":[{"name":"Hypertension and Vascular Research Unit, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montr\u00e9al, QC,","place":["Canada"]},{"name":"Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital, McGill University , Montr\u00e9al, QC,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ross D","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Western Ontario , London, ON,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhanu","family":"Prasad","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Medicine, Regina General Hospital, University of Saskatchewan , Regina, SK,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander A","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Medicine, University of Calgary , Calgary, AB,","place":["Canada"]},{"name":"Department of Community Health Sciences, University of Calgary , Calgary, AB,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Dubrofsky","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Women\u2019s College Hospital , Toronto, ON,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen C","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver, BC,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Madan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto , Toronto, ON,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Machan","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of British Columbia , Vancouver, BC,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadia","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of British Columbia , Vancouver, BC,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,6]]},"reference":[{"key":"2026052104375949700_hpaf236-B1","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1016\/j.cjco.2024.05.012","article-title":"Prevalence, patient awareness, treatment, and control of hypertension in Canadian adults with common comorbidities","volume":"6","author":"Leung","year":"2024","journal-title":"CJC Open"},{"key":"2026052104375949700_hpaf236-B2","doi-asserted-by":"publisher","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 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