Renal Denervation for Hypertension ― Mechanisms, Evidence, and Clinical Integration ―
Abstract
Renal denervation is a catheter-based therapy that interrupts renal sympathetic traffic and lowers blood pressure through durable neuromodulation. Contemporary catheter-based systems deliver energy to the periadventitial space with an acceptable safety profile. Across blinded placebo-controlled trials in off-medication and on-medication settings, renal denervation achieves greater reductions in ambulatory and office blood pressure than placebo, with a uniform 24-h effect that includes night-time and early-morning periods. Long-term follow-up data from randomized programs and large registries show sustained separation in blood pressure between renal denervation and control groups, preserved renal function, and low re-intervention rates over several years, with select cohorts approaching a decade. This review summarizes the mechanism and target anatomy of renal denervation, key features and results of placebo-controlled trials, and practical considerations for integrating the procedure with contemporary pharmacologic therapy in patients with uncontrolled hypertension.
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BibTeX
@article{sato2026renal,
title = {{Renal Denervation for Hypertension ― Mechanisms, Evidence, and Clinical Integration ―}},
author = {Takanori Sato and Yuichi Saito and Jiro Aoki and Eiichiro Yamamoto and Yuichiro Maekawa and Kazuomi Kario and Ken Kozuma and Yoshio Kobayashi},
journal = {Circulation Journal},
year = {2026},
month = sep,
doi = {10.1253/circj.cj-25-1042},
url = {https://www.jstage.jst.go.jp/article/circj/90/10/90_CJ-25-1042/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Renal Denervation for Hypertension ― Mechanisms, Evidence, and Clinical Integration ―
AU - Takanori Sato
AU - Yuichi Saito
AU - Jiro Aoki
AU - Eiichiro Yamamoto
AU - Yuichiro Maekawa
AU - Kazuomi Kario
AU - Ken Kozuma
AU - Yoshio Kobayashi
PY - 2026
DA - 2026/09/25
JO - Circulation Journal
DO - 10.1253/circj.cj-25-1042
UR - https://www.jstage.jst.go.jp/article/circj/90/10/90_CJ-25-1042/_article
AB - Renal denervation is a catheter-based therapy that interrupts renal sympathetic traffic and lowers blood pressure through durable neuromodulation. Contemporary catheter-based systems deliver energy to the periadventitial space with an acceptable safety profile. Across blinded placebo-controlled trials in off-medication and on-medication settings, renal denervation achieves greater reductions in ambulatory and office blood pressure than placebo, with a uniform 24-h effect that includes night-time and early-morning periods. Long-term follow-up data from randomized programs and large registries show sustained separation in blood pressure between renal denervation and control groups, preserved renal function, and low re-intervention rates over several years, with select cohorts approaching a decade. This review summarizes the mechanism and target anatomy of renal denervation, key features and results of placebo-controlled trials, and practical considerations for integrating the procedure with contemporary pharmacologic therapy in patients with uncontrolled hypertension.
SN - 1347-4820
SN - 1346-9843
ER -