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Effects of renal denervation on sympathetic activation, blood pressure, and glucose metabolism in patients with resistant hypertension

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posted on 2024-07-26, 14:21 authored by Markus P. Schlaich, Dagmara Hering, Paul Sobotka, Henry Krum, Gavin LambertGavin Lambert, Elisabeth LambertElisabeth Lambert, Murray D. Esler
Increased central sympathetic drive is a hallmark of several important clinical conditions including essential hypertension, heart failure, chronic kidney disease, and insulin resistance. Afferent signaling from the kidneys has been identified as an important contributor to elevated central sympathetic drive and increased sympathetic outflow to the kidney and other organs is crucially involved in cardiovascular control. While the resultant effects on renal hemodynamic parameters, sodium and water retention, and renin release are particularly relevant for both acute and long term regulation of blood pressure, increased sympathetic outflow to other vascular beds may facilitate further adverse consequences of sustained sympathetic activation such as insulin resistance, which is commonly associated with hypertension. Recent clinical studies using catheter-based radiofrequency ablation technology to achieve functional renal denervation in patients with resistant hypertension have identified the renal nerves as therapeutic target and have helped to further expose the sympathetic link between hypertension and insulin resistance. Initial data from two clinical trials and several smaller mechanistic clinical studies indicate that this novel approach may indeed provide a safe and effective treatment alternative for resistant hypertension and some of its adverse consequences.

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ISSN

1664-042X

Journal title

Frontiers in Physiology

Volume

3 FEB

Article number

article no. 10

Pagination

10-

Publisher

Frontiers Research Foundation

Copyright statement

Copyright © 2012 Schlaich, Hering, Sobotka, Krum, Lambert, Lambert and Esler. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits non-commercial use, distribution, and reproduction in other forums, provided the original authors and source are credited.

Language

eng

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