[PDF] The joint UK Societies' 2014 consensus statement on renal denervation for resistant hypertension

Source:
British and Irish Hypertension Society - BIHS
Publisher:
British and Irish Hypertension Society (BIHS);British Cardiovascular Society;Renal Association
Publication date:
27 November 2014

Abstract

Renal denervation for proven resistant hypertension is a new procedure with an emerging evidence base of effectiveness and safety. This Joint Societies’ Consensus Statement recommends reliance on the current evidence-base to select patients with resistant hypertension who may be eligible for this therapy. In trials, resistant hypertension was defined as a sustained clinic systolic blood pressure of = 160 mm Hg (= 150 mm Hg in Type 2 Diabetes) in patients on 3 or more anti-hypertensive medications. This is equivalent to stage 2 hypertension which is an average clinic blood pressure >160 mm Hg and equivalent to a daytime average on ambulatory blood pressure >150 mm Hg as defined by the 2011 National Institute for Health and Clinical Excellence (NICE CG 127) Hypertension Guideline . Also recommended is that to be eligible for renal denervation patients should have progressed through the medications recommended at step 4 in the NICE/British Hypertension Society Treatment Algorithm in CG 127 5 . Confirmation of sustained raised blood pressure using ambulatory blood pressure monitoring is essential (as above). It will allow detection of a “white coat”, or alerting response which may be a cause of apparently resistant hypertension.