Previous studies suggest that endovascular renal denervation reduces blood pressure (BP) in patients with mild-to-moderate hypertension. However, its efficacy in patients with resistant hypertension remains unknow. To assess the efficacy and safety of endovascular ultrasound renal denervation in patients aged 18-75 with office BP of 140/90 mm Hg despite three or more antihypertensives, including a diuretic, investigators first switched patients to a once daily combination of a calcium channel blocker, an angiotensin receptor blocker, and a thiazide diuretic. Participants with daytime ambulatory BP of at least 135/85 mm Hg after 4 weeks were randomized to denervation or a sham procedure. Daytime ambulatory systolic BP was reduced by 8 mm Hg with renal denervation, compared with a reduction of 3 mm Hg with the sham procedure. The median between-group difference was -5.8 mm Hg among patients with complete ambulatory BP data. No differences were observed between the groups in safety outcomes.
