Renale Denervation – Phoenix aus der Asche

Zusammenfassung

Die arterielle Hypertonie ist eine häufige und meistens unzureichend behandelte Erkrankung, die für eine Vielzahl von kardiovaskulären Komplikationen verantwortlich ist. Aufgrund der schlechten Therapieadhärenz resultieren Lebensstiländerungen und die medikamentöse Dauertherapie häufig nicht in einer ausreichenden Blutdrucksenkung. Die renale Denervation (RDN) hat damit das Potenzial, die bisherigen Strategien zur Therapie der arteriellen Hypertonie sinnvoll zu ergänzen. Unlängst haben mehrere randomisierte, unabhängige Studien das biologische Konzept der RDN eindeutig nachgewiesen. Dabei entspricht die erreichte Blutdrucksenkung im Mittel etwa dem eines Antihypertonikums. Unabhängig von der Therapietreue des Patienten ist die Wirkung anhaltend. Weitere klinische Untersuchung werden derzeit durchgeführt, um die bisherigen Ergebnisse zu festigen und bislang ungeklärte Fragen zu beantworten.

Abstract

Hypertension is a frequent disease responsible for many cardiovascular complications. However, lifelong polypharmacy is failing as a strategy to improve hypertension control. One reason is abysmal adherence to medication and lifestyle modifications. Renal denervation therefore is an additive treatment strategy in patients with uncontrolled hypertension. Proof of principle of renal denervation for hypertension in the absence and presence of drugs has been shown in well controlled randomized clinical trials. Blood pressure reduction by RDN equates one antihypertensive drug. Independently of adherence to medication RDN induces a permanent reduction of blood pressure. Further clinical trials are underway to corroborate the current results and to answer open questions.

Was ist wichtig?

Die Behandlung der arteriellen Hypertonie bleibt unzureichend. Die renale Denervation ist eine invasive Therapiestrategie, deren biologisches Konzept in mehreren unabhängigen, kontrollierten Studien eindeutig nachgewiesen wurde. Verschiedene Techniken zur Ablation sind in der klinischen Anwendung. Alle geprüften Verfahren sind sicher und führen zu einer klinisch relevanten Blutdrucksenkung. Damit ist die renale Denervation eine Erweiterung der therapeutischen Möglichkeiten bei Patienten mit Bluthochdruck.

Schlüsselwörter

renale Denervation - Verfahren - neue klinische Studien

Keywords

renal denervation - devices - new clinical trials

Publication History

Article published online:
12 April 2022

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