Renal Sympathetic Denervation for the Management of Chronic Hypertension
Condition: Uncontrolled Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      Despite the development of numerous drug therapies designed to treat hypertension, it remains
      a considerable and poorly managed health, social and economic burden. For various reasons,
      including the significant health care costs of treatment, there are estimates that up to 65%
      of hypertensive patients have untreated and/or uncontrolled blood pressure (BP).

      Aside from its impact on renal function, chronic hypertension significantly increases the
      risk for stroke, coronary artery disease, heart failure, and vascular disease. It is believed
      to be involved in the progression of cardiac arrhythmias. This link between hypertension and
      cardiovascular health has been well described; as has their combined effect on the aging and
      obesity-battling Western world.

      The recently published results of the Symplicity HTN-2 trial (Renal sympathetic denervation
      in patients with treatment resistant hypertension) establishing the therapeutic benefit of
      catheter-based renal sympathetic denervation for hypertension, have enormous potential for
      the management of a large and challenging patient population. The proposed, multicenter trial
      will attempt to confirm and expand on this promising data by conducting a double-blinded,
      placebo-controlled trial.

      Patients may qualify to participate in this research study if their doctor has determined
      that they have drug-resistant, chronic hypertension.

      Overall participation in this research study should be about 13 months which includes about 1
      month to start the study procedure and 12 months of follow-up after the study procedure.
    

Detailed description: 
      Patients who qualify for the study and provide consent will undergo a renal angiogram in
      order to assess suitability for catheter-based renal sympathetic denervation. A renal
      angiogram is an x-ray study of the blood vessels in the kidney to evaluate for blockage, and
      abnormalities that could be affecting the blood supply to the kidney. It is performed by
      injecting contrast dye through a catheter (a tiny tube) into the blood vessels of the kidney.
      The study doctor will assess whether the renal arteries are suitable to receive
      catheter-based renal denervation.

      Both groups will receive sedation or anesthesia prior to the beginning of the procedure.

      The first group will undergo catheter-based sympathetic renal denervation. Renal Sympathetic
      Denervation is a procedure that uses a catheter probe inserted into the renal (kidney) artery
      that deactivates the nerves that are linked to high blood pressure.

      The second group will only receive renal angiography without the delivery of ablative energy.
    

Intervention name(s): Biosense Webster Celcius Thermacool catheter
Intervention type(s): Device
Intervention description(s): catheter-based sympathetic renal denervation
Other intervention name(s): sympathetic renal denervation; Ablation arm
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: renal sympathetic denervation; renal catheter ablation; hypertension