- Question
- Does endovascular ultrasound renal denervation lower blood pressure in patients with truly resistant hypertension despite standardised triple therapy?
- Design
- Randomised 1:1, international, multicentre, single-blind, sham-controlled trial conducted at 28 tertiary centres in the USA and 25 in Europe; patients and outcome assessors were masked.
- Population
- Adults aged 18 to 75 years with office blood pressure of at least 140/90 mm Hg despite three or more antihypertensive drugs including a diuretic. After 4 weeks on a standardised single-pill combination, those with daytime ambulatory blood pressure of at least 135/85 mm Hg were randomised (136 randomised out of 989 enrolled).
- Intervention
- Endovascular ultrasound renal denervation (69 patients), on top of the single-pill combination of a calcium channel blocker, an angiotensin receptor blocker and a thiazide diuretic.
- Control
- Sham procedure (67 patients), with the same background single-pill combination.
- Primary outcome
- Change in daytime ambulatory systolic blood pressure at 2 months in the intention-to-treat population.
- Results
- Renal denervation reduced daytime ambulatory systolic blood pressure more than the sham procedure (-8.0 mm Hg vs -3.0 mm Hg); the median between-group difference was -4.5 mm Hg (95% CI -8.5 to -0.3; adjusted p=0.022). Among patients with complete ambulatory data the difference was -5.8 mm Hg (95% CI -9.7 to -1.6; adjusted p=0.0051).
- Safety
- There were no differences in safety outcomes between the two groups.
- Conclusion
- In patients with hypertension resistant to a standardised triple-combination pill, ultrasound renal denervation lowered blood pressure at 2 months compared with a sham procedure.
- Why it matters
- It provided sham-controlled evidence that renal denervation can lower blood pressure in truly resistant hypertension, suggesting an alternative to adding further medications if the effect and safety are maintained long term.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026