Debate: Renal denervation. The interventional cardiologist perspective

QUESTION: After the negative results of the SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) study, what new studies are dealing with renal denervation (RD) as a possible therapeutic option? ANSWER: The results of the SYMPLICITY HTN-3 study1 were totally unexpected, particularly because those of us who had some sort of experience with this technique had lived a completely dif-ferent reality. The limitations of the study have to do with the arguable selection of patients (with non-optimized pharmacological treatment that was adjusted during follow-up and generated an unexpectedly positive response in the control group), the operators' lack of experience (most of them conducted their first procedures within the study), and the lack of knowledge on how to conduct this procedure in order to optimize the results. After the detailed analysis of the SYMPLICITY HTN-3 study,1 two different studies were designed with an improved device to conduct the procedure and their results have recently been made public. The first study, the SPYRAL HTN-OFF MED2 was a randomized sham-controlled clinical trial (with a sham control group) as the proof-of-concept on the efficacy of RD to reduce arterial blood pressure (BP) in patients without concomitant pharmacological treatment. Patients with mild-to-moderate arterial hypertension (HT) (office systolic...