Objective: To examine whether Sympathetic Renal Denervation (RDN) might have an additive value for cardiovascular risk decline beyond lowering blood pressure. Methods: 73 selected patients with resistant hypertension had RDN performed. Arterial stiffness was measured, using applanation tonometry, before the procedure, 24 to 48 hours following the procedure and subsequently 1, 3 and 6 months after the RDN. Results: Within 48 hours RDN significantly reduced carotid-femoral aortic pulse wave

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... ty (AoPWV) from 11.3 AE 2.7 to 10.3 AE 2.6 m/s (p Z 0.001), the reduction was sustained at months 1, 3, and 6. Early changes of AoPWV value did not correlate with office systolic or diastolic BP (p Z 0.45; p Z 0.33). Furthermore, the higher the initial AoPWV value, the greater the reduction of AoPWV was observed after 6 months: Q1 8.4 AE 1, D 0.05 AE 1.6/Q2 10.1 AE 0.4, D 1.1 AE 1.4/Q3 12.2AE0.8, D 1.8 AE 1.7/Q4 15.3 AE 1.7, D 2.8 AE 2.1, (p Z 0.002). Conclusion: A sustainable effect on AoPWV, observed in our study as early as within 24-48 hours following the procedure and up to 6 months, suggests an additional RDN effect on reducing arterial stiffness and cardiovascular risk. The de-stiffening effect was greater in patients with high initial AoPWV.