TY - CHAP M1 - Book, Section TI - Renal Denervation: Pathophysiology, Techniques, and Clinical Data A1 - Corrigan III, Frank E. A1 - Devireddy, Chandan M. A2 - Samady, Habib A2 - Fearon, William F. A2 - Yeung, Alan C. A2 - King III, Spencer B. PY - 2017 T2 - Interventional Cardiology, 2e AB - Hypertension is a common, modifiable risk factor of cardiovascular mortality. At present, 30% to 40% of adults in developed countries suffer from hypertension.1 When hypertension was first recognized, control was difficult due to limited treatment options and often regarded as a fruitless endeavor. In 1931, Dr. Paul Dudley White wrote, “Hypertension may be an important compensatory mechanism which should not be tampered with, even were it certain that we could control it.”2 Starting in the 1930s, surgical sympathectomy to reduce sympathetic tone was observed to significantly lower blood pressure at the expense of significant procedural morbidity and long-term disability. It was not until the late 1960s that pharmacotherapy for hypertension became available and widespread. Pharmacologic treatment for hypertension has proven generally effective, spurred development of many classes of medications, and assisted in the reduction in mortality from cardiovascular disease. Despite this success, many patients have hypertension that remains uncontrolled. Many cases of uncontrolled hypertension may be attributed to inaction or lack of awareness on the part of patient or provider, but the prevalence of true treatment-resistant hypertension is increasing. In recent years, interest in modifying the sympathetic nervous system has reemerged with the advent of novel minimally invasive methods such as catheter-based renal artery denervation that can potentially restore more balanced autonomic nervous system physiology and offer alternative treatment options for systemic conditions such as hypertension. In this chapter, we will review what is known about the efficacy of catheter-directed autonomic modulation as a novel treatment of hypertension, discuss best practices to achieve desired results, and outline what the future may hold for this controversial area of endovascular medicine. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesscardiology.mhmedical.com/content.aspx?aid=1146604810 ER -