Selective vs. Global Renal Denervation: a Case for Less Is More.

Abstract:

PURPOSE OF REVIEW:Review the renal nerve anatomy and physiology basics and explore the concept of global vs. selective renal denervation (RDN) to uncover some of the fundamental limitations of non-targeted renal nerve ablation and the potential superiority of selective RDN. RECENT FINDINGS:Recent trials testing the efficacy of RDN showed mixed results. Initial investigations targeted global RDN as a therapeutic goal. The repeat observation of heterogeneous response to RDN including non-responders with lack of a BP reduction, or even more unsettling, BP elevations after RDN has raised concern for the detrimental effects of unselective global RDN. Subsequent studies have suggested the presence of a heterogeneous fiber population and the potential utility of renal nerve stimulation to identify sympatho-stimulatory fibers or "hot spots." The recognition that RDN can produce heterogeneous afferent sympathetic effects both change therapeutic goals and revitalize the potential of therapeutic RDN to provide significant clinical benefits. Renal nerve stimulation has emerged as potential tool to identify sympatho-stimulatory fibers, avoid sympatho-inhibitory fibers, and thus guide selective RDN.

journal_name

Curr Hypertens Rep

authors

Fudim M,Sobotka AA,Yin YH,Wang JW,Levin H,Esler M,Wang J,Sobotka PA

doi

10.1007/s11906-018-0838-2

subject

Has Abstract

pub_date

2018-05-01 00:00:00

pages

37

issue

5

eissn

1522-6417

issn

1534-3111

pii

10.1007/s11906-018-0838-2

journal_volume

20

pub_type

杂志文章,评审
  • First Course DASH, Second Course Mediterranean: Comparing Renal Outcomes for Two "Heart-Healthy" Diets.

    abstract:PURPOSE OF REVIEW:To review studies evaluating renal outcomes based on patient adherence to the Mediterranean diet or to the Dietary Approaches to Stop Hypertension (DASH) diet and to determine which diet is most effective in preventing and managing renal disease. RECENT FINDINGS:Both the DASH and Mediterranean diets ...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-020-01054-0

    authors: Yazdi F,Morreale P,Reisin E

    更新日期:2020-07-15 00:00:00

  • Immune mechanisms in hypertension.

    abstract::Inflammation plays an important role in the pathogenesis of hypertension. Innate and adaptive immune response may contribute to this process. The mechanisms implicating immune response in hypertension are still elusive. To date, the evidence originates in three major areas of data: cytokine production, central nervous...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-011-0224-9

    authors: Leibowitz A,Schiffrin EL

    更新日期:2011-12-01 00:00:00

  • Dual blockade of the renin angiotensin system in diabetic and nondiabetic kidney disease.

    abstract::Dual blockade of the renin angiotensin system is based on a principle of obtaining the broadest and most efficient blockade of the effects of angiotensin II, by using the combination of an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin II-receptor blocker (ARB). By combining two, different pharmacolo...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-004-0056-y

    authors: Andersen NH,Mogensen CE

    更新日期:2004-10-01 00:00:00

  • Management of hypertension and diabetes: treatment goals, drug choices, current practice, and strategies for improving care.

    abstract::Diabetes and hypertension are common coexistent conditions, the combination of which results in an increased risk for cardiovascular and renal disease. Clinical trials have convincingly demonstrated the benefit of tight blood pressure control among patients with diabetes in reducing these risks. Furthermore, the choic...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-005-0039-7

    authors: Borzecki AM,Berlowitz DR

    更新日期:2005-12-01 00:00:00

  • How does preeclampsia predispose to future cardiovascular disease?

    abstract::Over the last few decades, there has been increasing emphasis on cardiovascular disease in women and study of female-specific cardiovascular risk factors. Hypertension in pregnancy, and specifically preeclampsia, has been identified as one such risk factor. In this review, we explore the epidemiological evidence for p...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-014-0472-6

    authors: Scantlebury DC,Hayes SN

    更新日期:2014-09-01 00:00:00

  • Hypertension in multicultural and minority populations: linking communication to compliance.

    abstract::Cardiovascular disease disproportionately affects minority populations, in part because of multiple sociocultural factors that directly affect compliance with antihypertensive medication regimens. Compliance is a complex health behavior determined by a variety of socioeconomic, individual, familial, and cultural facto...

    journal_title:Current hypertension reports

    pub_type: 杂志文章

    doi:10.1007/BF03215777

    authors: Betancourt JR,Carrillo JE,Green AR

    更新日期:1999-12-01 00:00:00

  • Diabetic cardiomyopathy.

    abstract::Diabetes mellitus is well recognized as a potent and prevalent risk factor for accelerated atherosclerosis and ischemic heart disease. However, there is also evidence of cardiac dysfunction in diabetes in the absence of coronary atherosclerosis, termed diabetic cardiomyopathy. Changes in ventricular structure and left...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-007-0086-3

    authors: Karnik AA,Fields AV,Shannon RP

    更新日期:2007-12-01 00:00:00

  • Epidemiology of pulmonary arterial hypertension.

    abstract::The epidemiology of pulmonary arterial hypertension (PAH) has changed over the last decade. Remarkable advances in understanding the pathobiology and clinical care required in PAH have resulted in improved quality of life and survival. Despite such important progress, the long-term rate of survival is still unacceptab...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-013-0397-5

    authors: Jiang X,Jing ZC

    更新日期:2013-12-01 00:00:00

  • Endothelin antagonism and its role in the treatment of hypertension.

    abstract::Hypertension contributes greatly to global disease burden and in many patients current treatments do not adequately control blood pressure (BP). Endothelin-1 (ET-1) is a potent vasoconstrictor that is implicated in the pathogenesis of hypertension, including the hypertension that is often associated with chronic kidne...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-013-0380-1

    authors: Moorhouse RC,Webb DJ,Kluth DC,Dhaun N

    更新日期:2013-10-01 00:00:00

  • Cognitive function in hypertensive children.

    abstract::Young hypertensive adults demonstrate decreased performance on neurocognitive testing compared with that of normotensive controls. There is emerging, preliminary evidence that children with hypertension also manifest cognitive differences when compared to normotensive controls. These preliminary studies consist mostly...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-014-0508-y

    authors: Lande MB,Kupferman JC

    更新日期:2015-01-01 00:00:00

  • Integrative Physiological Aspects of Brain RAS in Hypertension.

    abstract:PURPOSE OF REVIEW:The renin-angiotensin system (RAS) plays an important role in modulating cardiovascular function and fluid homeostasis. While the systemic actions of the RAS are widely accepted, the role of the RAS in the brain, its regulation of cardiovascular function, and sympathetic outflow remain controversial. ...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-018-0810-1

    authors: de Morais SDB,Shanks J,Zucker IH

    更新日期:2018-02-26 00:00:00

  • The use of calcium antagonists in the treatment of hypertensive persons with kidney disease.

    abstract::The treatment of hypertension is proven to reduce cardiovascular and renal risk. Combination drug therapy is becoming recognized as a necessity in most patients with hypertension and kidney disease. Allegations about the safe use of calcium antagonists in patients with kidney disease have led to questions and confusio...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-002-0006-5

    authors: Tobe S,Epstein M

    更新日期:2002-06-01 00:00:00

  • From Clinical Trials to Bedside: the Use of Antihypertensives in Aged Individuals. Part 2: Approach to Treatment.

    abstract:PURPOSE OF REVIEW:Use of antihypertensives in older adults can be complicated by the potential for undesired effects on comorbidities, adverse effects of the drugs, and overall medication burden. The purpose of this two-part review is to discuss contemporary issues encountered in the management of hypertension in aged ...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-019-0988-x

    authors: Ernst ME,MacLaughlin EJ

    更新日期:2019-10-10 00:00:00

  • Obesity and hypertension in the Argentinian population compared to the white Hispanic population of the United States.

    abstract::Hypertension and obesity are two closely related pathologies in clinical practice. Currently, about one billion adults worldwide are overweight, and it is estimated that, if no serious action is taken to effect profound change, that figure will continue to rise throughout this century. Hypertension is also a serious p...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-014-0438-8

    authors: Díaz MG,Rusak EJ,Aguilar EA,Bellido CA

    更新日期:2014-07-01 00:00:00

  • Effects of gender on the renin-angiotensin system, blood pressure, and renal function.

    abstract::Recent studies have identified key gender differences in cardiovascular function, renal hemodynamics, and the renin-angiotensin system. Extensive epidemiologic evidence has shown a clear gender difference in cardiovascular and renal disease progression, whereby female sex appears to be protective. The mechanisms under...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-002-0039-9

    authors: Kang AK,Miller JA

    更新日期:2002-04-01 00:00:00

  • The Role of Interleukin-10 in the Pathophysiology of Preeclampsia.

    abstract:PURPOSE OF REVIEW:The pathophysiology of preeclampsia is complex and not entirely understood. A key feature in preeclampsia development is an immunological imbalance that shifts the maternal immune response from one of tolerance towards one promoting chronic inflammation and endothelial dysfunction. As a key regulator ...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-018-0833-7

    authors: Cubro H,Kashyap S,Nath MC,Ackerman AW,Garovic VD

    更新日期:2018-04-30 00:00:00

  • Isolated Systolic Hypertension in Young and Middle-Aged Adults.

    abstract::Young and middle-aged adults (ages ≤50 years) are increasingly prone to stroke, kidney disease, and worsening cardiovascular disease (CVD) mortality. An alarming increase in the prevalence of high blood pressure (BP) may underlie the adverse trend. However, there is often uncertainty in BP management for young and mid...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-016-0686-x

    authors: Yano Y,Lloyd-Jones DM

    更新日期:2016-11-01 00:00:00

  • Organ selective regulation of sympathetic outflow by the brain Angiotensin system.

    abstract::Angiotensin II (Ang II) has actions on the sympathetic nervous system both as a circulating hormone acting on the circumventricular organs and also as a neurotransmitter/ neuromodulator acting within the brain. Administration of Ang II into the cerebral ventricles has diverse effects on sympathetic nerve activity (SNA...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-013-0355-2

    authors: Ramchandra R,Yao ST,May CN

    更新日期:2013-08-01 00:00:00

  • Neurogenic factors in renal hypertension.

    abstract::Hypertension is very common in patients with chronic renal failure and contributes to cardiovascular morbidity and mortality. Several mechanisms may contribute to hypertension in these patients, but recently a large body of evidence supports the notion that activation of the sympathetic nervous system (SNS) may play a...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-002-0016-3

    authors: Campese VM,Krol E

    更新日期:2002-06-01 00:00:00

  • Recent advances in the management of hypertension in the elderly.

    abstract::Important new advances have occurred in our understanding and approach to management of high blood pressure in the elderly. New clinical trials have re-emphasized the risk of development of cardiovascular and cerebrovascular complications associated with isolated elevations in systolic blood pressure as well as the sa...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-996-0039-2

    authors: Gennari FJ,Gennari AS

    更新日期:2000-12-01 00:00:00

  • Is population-wide diuretic use directly associated with the incidence of end-stage renal disease in the United States?

    abstract::In the quest for "evidence-based" medicine, an accepted hierarchy of evidence has been proposed. This hierarchy places in vitro studies and animal data at the base, and puts systematic reviews, meta-analyses, and randomized controlled trials at the pinnacle. However, when clinical medicine faces questions that have no...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-006-0054-3

    authors: Hawkins RG

    更新日期:2006-06-01 00:00:00

  • The Role of CNS in the Effects of Salt on Blood Pressure.

    abstract::Sympathetic nerve activity is involved in the pathogenesis of salt-sensitive hypertension. The central nervous system, which regulates sympathetic nerve activity and blood pressure, plays a pivotal role. Central sympathoexcitation is deeply involved in the pathogenesis of salt-sensitive hypertension, although the prec...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-015-0620-7

    authors: Fujita M,Fujita T

    更新日期:2016-02-01 00:00:00

  • Blood pressure control in the elderly: can you have too much of a good thing?

    abstract::Hypertension (especially systolic hypertension) is very common in older persons. Systolic hypertension occurs because large conduit arteries become stiffer with age. Strong evidence from randomized trials suggests that treating systolic blood pressures initially higher than 160 mm Hg is extremely beneficial, and a rec...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-009-0057-y

    authors: Hyman DJ,Taffet GE

    更新日期:2009-10-01 00:00:00

  • Investigating Maternal Brain Alterations in Preeclampsia: the Need for a Multidisciplinary Effort.

    abstract:PURPOSE OF REVIEW:To provide insight into the mechanisms underlying cerebral pathophysiology and to highlight possible methods for evaluation, screening, and surveillance of cerebral complications in preeclampsia. RECENT FINDINGS:The pathophysiology of eclampsia remains enigmatic. Animal studies show that the cerebral...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-019-0977-0

    authors: Bergman L,Torres-Vergara P,Penny J,Wikström J,Nelander M,Leon J,Tolcher M,Roberts JM,Wikström AK,Escudero C

    更新日期:2019-08-02 00:00:00

  • Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa.

    abstract:PURPOSE OF REVIEW:To review the current literature on use of telehealth at different stages of the hypertension control cascade in sub-Saharan Africa (SSA) and to discuss opportunities to harness technology infrastructure in SSA to improve population-level blood pressure control. RECENT FINDINGS:Despite the high burde...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-019-0983-2

    authors: Muiruri C,Manavalan P,Jazowski SA,Knettel BA,Vilme H,Zullig LL

    更新日期:2019-08-26 00:00:00

  • Renal Denervation in Heart Failure.

    abstract::Heart failure has emerged as one of the most important diseases of the past century. The understanding and treatment of heart failure has evolved significantly over the years. As we move further into the era of device therapy, attention has turned to the idea of sympathetic nervous system modulation through renal dene...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-014-0528-7

    authors: Fong MW,Shavelle D,Weaver FA,Nadim MK

    更新日期:2015-03-01 00:00:00

  • Electrical stimulation of the carotid sinus for the treatment of resistant hypertension.

    abstract::Hypertension is a major cause of morbidity and mortality worldwide. Despite a myriad of oral agents, many patients fail to reach their target blood pressure. Electrical stimulation of the carotid sinus, an old therapeutic concept, lowers blood pressure by initiating the baroreflex and reducing sympathetic tone. Recent...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-006-0089-5

    authors: Filippone JD,Sloand JA,Illig KA,Bisognano JD

    更新日期:2006-10-01 00:00:00

  • Endothelin Receptor Antagonists: New Hope for Renal Protection?

    abstract::Endothelin receptor antagonists (ERAs) have the potential to be a new paradigm in the treatment of chronic kidney disease (CKD). ERAs inhibit the effects of endothelin-1 (ET-1), which is known to promote CKD by causing renal cellular injury, proteinuria, inflammation, fibrosis, and hypertrophy. ERAs have been extensiv...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-015-0568-7

    authors: Tobe S,Kohan DE,Singarayer R

    更新日期:2015-07-01 00:00:00

  • Effects of antihypertensive treatment on endothelial function.

    abstract::Essential hypertension is characterized by endothelial dysfunction due to reduced availability of nitric oxide (NO) secondary to increased generation of oxygen-free radicals. Some antihypertensive drugs may improve or restore endothelial function independently of their blood pressure lowering effect. The newer generat...

    journal_title:Current hypertension reports

    pub_type: 杂志文章

    doi:10.1007/s11906-011-0207-x

    authors: Virdis A,Ghiadoni L,Taddei S

    更新日期:2011-08-01 00:00:00

  • Blood Pressure and Statin Effects on Cognition: a Review.

    abstract:PURPOSE OF REVIEW:This is a review of available data on the effects of blood pressure and statins on cognition. RECENT FINDINGS:Recent randomized clinical trials have shown that intensive control of systolic blood pressure in older adults prevented the development of mild cognitive impairment (MCI) and the combined ef...

    journal_title:Current hypertension reports

    pub_type: 杂志文章,评审

    doi:10.1007/s11906-019-0973-4

    authors: Yang M,Williamson J

    更新日期:2019-07-26 00:00:00