{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:51:19Z","timestamp":1792713079272,"version":"4.5.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The SPYRAL HTN\u2010ON MED (Global Clinical Study of Renal Denervation With the Symplicity Spyral Multielectrode Renal Denervation System in Patients With Uncontrolled Hypertension on Standard Medical Therapy) trial showed that radiofrequency renal denervation (RDN) using the Symplicity Spyral catheter yielded significant blood pressure (BP) reductions at 6 and 24\u2009months compared with sham control in patients with hypertension on antihypertensive medications. In this prespecified analysis through the final follow\u2010up, we evaluate the durability of BP reductions, antihypertensive medication use, and safety through 3\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">SPYRAL HTN\u2010ON MED is a global, randomized, sham\u2010controlled trial enrolling patients with uncontrolled hypertension. Patients were prescribed 1 to 3 antihypertensive medications and randomized to RDN or a sham procedure. After 6\u2009months, patients were unblinded, and sham patients could cross over to RDN. Crossover patients' values for BP and antihypertensive medications were imputed to 36\u2009months using their last observation before crossover to RDN carried forward. Statistical analyses, including imputation, were exploratory and conducted on the intention\u2010to\u2010treat population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      After 6\u2009months, 74% of sham patients crossed over to undergo RDN. Patients undergoing RDN had statistically significant 24\u2010hour ambulatory systolic BP reductions (treatment difference, \u20134.7\u2009mm\u2009Hg;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.0028) and office systolic BP reductions (difference, \u20137.5\u2009mm\u2009Hg;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.0002) compared with the sham control group through 36\u2009months. At 36\u2009months, the antihypertensive medication burden was balanced between groups (RDN, 5.2\u00b15.0 versus 5.5\u00b19.9;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.63). Crossover patients had significantly better office BP control after RDN. Clinical adverse events were rare.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Compared with sham patients through 3\u2009years, patients undergoing RDN had significantly greater 24\u2010hour ambulatory and office BP reductions, with a similar medication burden. RDN maintained a durable safety profile through 3\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>REGISTRATION<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\">https:\/\/clinicaltrials.gov\/study<\/jats:ext-link>\n                      ; Unique identifier: NCT02439775.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049081","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:13:53Z","timestamp":1781525633000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Three\u2010Year Durability of Radiofrequency Renal Denervation: SPYRAL HTN\u2010ON MED"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0868-6655","authenticated-orcid":false,"given":"David E.","family":"Kandzari","sequence":"first","affiliation":[{"name":"Piedmont Heart Institute","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-549X","authenticated-orcid":false,"given":"Felix","family":"Mahfoud","sequence":"additional","affiliation":[{"name":"University Hospital Basel","place":["Switzerland"]},{"name":"University Hospital Basel","place":["Basel, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3215-9118","authenticated-orcid":false,"given":"Raymond R.","family":"Townsend","sequence":"additional","affiliation":[{"name":"University of Pennsylvania","place":["Philadelphia, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8251-4480","authenticated-orcid":false,"given":"Kazuomi","family":"Kario","sequence":"additional","affiliation":[{"name":"Jichi Medical University School of Medicine","place":["Tochigi, Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8504-0831","authenticated-orcid":false,"given":"Michael A.","family":"Weber","sequence":"additional","affiliation":[{"name":"SUNY Downstate College of Medicine","place":["New York, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2356-5883","authenticated-orcid":false,"given":"Roland E.","family":"Schmieder","sequence":"additional","affiliation":[{"name":"University Hospital Erlangen","place":["Erlangen, 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