Ralph DAgostino.

Deepak L. Bhatt, M.D http://viagradanmark.org ., M.P.H., David E. Kandzari, M.D., William W. O’Neill, M.D., Ralph D’Agostino, Ph.D., John M. Flack, M.D., M.P.H., Barry T. Katzen, M.D., Martin B. Leon, M.D., Minglei Liu, Ph.D., Laura Mauri, M.D., Manuela Negoita, M.D., Sidney A. Cohen, M.D., Ph.D., Suzanne Oparil, M.D., Krishna Rocha-Singh, M.D., Raymond R. Townsend, M.D., and George L. Bakris, M.D. For the SYMPLICITY HTN-3 Investigators: A Managed Trial of Renal Denervation for Resistant Hypertension Because of the aging of the populace and rising prices of weight problems, hypertension is increasing in prevalence worldwide.1 Approximately 10 percent of sufferers with diagnosed hypertension possess resistant hypertension, defined as a systolic blood pressure of 140 mm Hg or higher despite adherence to at least three maximally tolerated doses of antihypertensive medications from complementary classes, including a diuretic at an appropriate dose.1-4 Sufferers with resistant hypertension who are receiving appropriate medical therapy have high rates of cardiovascular complications, with few treatment options.5 In an previously era, nonrandomized studies demonstrated that medical sympathectomy was a highly effective treatment for some sufferers with uncontrolled hypertension, but profound orthostasis commonly happened after the procedure, and it fell into obsolescence.6,7 Recently, catheter-based radiofrequency denervation of the renal arteries has emerged as a potential treatment for resistant hypertension and has already been in clinical use in a lot more than 80 countries, including elements of Europe, SOUTH USA, Australia, and Canada.8-10 Initial nonrandomized research and randomized, unblinded trials have shown large reductions in blood pressure, as measured at an office visit, after renal denervation.11,12 However, several limitations of these studies, including small sample sizes, limited assessment of ambulatory blood circulation pressure, insufficient blinding, and lack of a sham procedure as a control, produce broad software of the results unreliable.

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