Hypertension is a leading risk factor for cardiovascular morbidity and mortality. Despite the widespread availability of both pharmacological and lifestyle therapeutic options, blood pressure control rates across the globe are worsening. In fact, only 23% of individuals with high blood pressure in the United States achieve treatment goals. In 2023, the US Food and Drug Administration approved renal denervation, a catheter-based procedure that ablates the renal sympathetic nerves, as an adjunctive treatment for patients in whom lifestyle modifications and antihypertensive medications do not adequately control blood pressure. This approval followed the publication of multiple randomized clinical studies using rigorous trial designs, all incorporating renal angiogram as the sham control. Most but not all of the new generation of trials reached their primary end point, demonstrating modest efficacy of renal denervation in lowering blood pressure across a spectrum of hypertension, from mild to truly resistant. Individual patient responses vary, and further research is needed to identify those who may benefit most. The initial safety profile appears favorable, and multiple ongoing studies are assessing longer-term efficacy and safety. Multidisciplinary teams that include hypertension specialists and adequately trained proceduralists are crucial to ensure that referrals are made appropriately with full consideration of the potential risks and benefits. Incorporating patient preferences and engaging in shared decision-making conversations will help patients make the best decisions given their individual circumstances. Although further research is clearly needed, renal denervation presents a novel treatment strategy for patients with uncontrolled blood pressure.

中文翻译：

---

肾去神经术治疗高血压：美国心脏协会的科学声明。


高血压是心血管疾病发病率和死亡率的主要危险因素。尽管药物和生活方式治疗选择广泛存在，但全球范围内的血压控制率正在恶化。事实上，在美国，只有 23% 的高血压患者达到了治疗目标。 2023 年，美国食品和药物管理局批准了肾去神经术，这是一种基于导管的手术，可消融肾交感神经，作为生活方式改变和抗高血压药物无法充分控制血压的患者的辅助治疗。此次批准是在使用严格试验设计的多项随机临床研究发表之后发布的，所有研究都纳入了肾血管造影作为假手术对照。大多数（但不是全部）新一代试验都达到了主要终点，证明去肾神经术在降低从轻度到真正难治性高血压的整个范围内的血压方面具有一定的功效。个体患者的反应各不相同，需要进一步研究来确定哪些人可能受益最多。最初的安全性似乎良好，多项正在进行的研究正在评估长期疗效和安全性。包括高血压专家和训练有素的程序专家在内的多学科团队对于确保在充分考虑潜在风险和益处的情况下适当转诊至关重要。纳入患者偏好并参与共同决策对话将帮助患者根据个人情况做出最佳决策。尽管显然还需要进一步的研究，但去肾神经术为血压不受控制的患者提供了一种新的治疗策略。