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Taking the hype out of hypertension

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Recently, the world's first blinded randomised controlled trial of renal sympathetic denervation in patients with resistant hypertension (SYMPLICITY HTN-3) reported its findings amidst much hope and hype.1 Renal sympathetic denervation involves percutaneous catheter-based radiofrequency ablation of nerves around the renal artery to reduce sympathetic afferent and efferent activity. Preceding unblinded studies had suggested that the procedure was associated with an impressive reduction in systolic blood pressure of around 30mmHg.2,3 Beyond the field of hypertension, renal denervation therapy had even been suggested to offer benefit in conditions including heart failure, diabetes, chronic renal failure and obstructive sleep apnoea.4 Thus, it is not surprising that the medical community has expressed disappointment that the fall in blood pressure …

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