Activation of renal sympathetic nerves contributes to the pathogenesis of hypertension. Catheter-based renal sympathetic denervation (RDN) may reduce blood pressure (BP) in patients with treatment-resistant hypertension. Methods: Patients with systolic BP ≥160 mm Hg despite optimal treatment with 3 or more antihypertensive drugs were randomized to treatment by RDN or to a control group maintained on previous treatment alone. At 6 months control patients were eligible to crossover to RDN. The

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... mary endpoint was change in systolic BP at 6 months. All patients were followed for 1 year to assess long-term effectiveness and safety of RDN. Results: There were 106 patients randomized to immediate RDN (n=52; 49 treated) or control (n=54; 46 crossed over to RDN). At 12 months data for 47 RDN patients and 35 crossover patients is available. At baseline, 32.7% of patients in the RDN and 60.0% of patients in the crossover group were female and type II diabetes mellitus was present in 42.9% and 28.6% of patients in the RDN and crossover groups, respectively. One patient in the crossover group had a right renal artery dissection. No other serious procedure-related adverse events and no radiofrequency-related renal artery stenosis or aneurysm occurred in either treatment group. Post-procedure BP changes for each group are shown below. Conclusions: Patients crossed over to RDN at 6 months had a similar significant drop in BP as patients receiving immediate RDN. RDN provides safe and durable reduction of BP to 1 year.