RESUMO
INTRODUCTION: Resistant hypertension is a commonplace condition among patients referred to specialty hypertension clinics, which is associated with increased morbidity and mortality. Refractory hypertension however is a rare extreme subtype of resistant hypertension in which blood pressure is uncontrolled despite treatment with five antihypertensive drug classes including a diuretic and a mineralocorticoid receptor antagonist, and is associated with even worse prognosis. We herein describe a 40-year-old woman with severe refractory hypertension and target organ damage for who percutaneous renal sympathetic denervation successfully reduced blood pressure to normal levels and alleviated chronic headaches. Renal denervation should be considered in patients with refractory hypertension, especially when sympathetic over-activity is suspected.