[Interventional treatment of high blood pressure-Current state]. / Interventionelle Therapien bei Hypertonie ­ aktueller Stand.

ABSTRACT

Arterial hypertension is a real global burden with a very high prevalence. In the last decades, many pharmaceutical approaches have been successfully developed for treating hypertension. Currently, novel medications for influencing blood pressure are not in sight. In recent years alternatives, such as interventional procedures for reducing blood pressure, have been developed and tested. Ablation of the renal sympathetic nerves (renal denervation, RDN), which are wrapped around the renal arteries in particular, has been intensively investigated as a procedure. After the first RDN studies a clear influence on the blood pressure could be shown; however, in the first sham-controlled studies the reduction in blood pressure by RDN could no longer consistently be shown. In very systematic sham-controlled, blinded studies in patients with hypertension but without medication a robust blood pressure reducing effect of RDN could be shown, which corresponded to the effect of a blood pressure-reducing drug. It is obvious that larger studies and also long-term studies have to sustainably confirm this effect. In recent years, active and passive stimulation of the baroreceptors could also be established as a blood pressure reducing principle, at least in studies but the evidence is still very low.