刘健,王岚,孙浩宁

• 1:北京大学人民医院心血管内科

摘要(Abstract)：

<正>美国心脏病学会和美国心脏协会（American CollegeofCa rdiology,ACC/America nHea r t Association,AHA）2017年发布的高血压管理指南~([1])将高血压重新定义为收缩压≥130mm Hg(1 mmHg=0.133 kPa)或舒张压≥80 mmHg；这一定义使美国成年人的高血压患病率增至45.6%，药物控制高血压的有效率降至39.0%,40%的血压未达标患者是由于不能坚持服药。经导管去肾交感神经（renal denervation,RDN）术是一种通过介入方式破坏肾动脉壁内的交感神经纤维，从而降低交感神经兴奋性，实现降压的新兴技术。

关键词(KeyWords)： 经导管去肾交感神经;高血压;降压

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（11832003）;; 北京大学人民医院研究与发展基金项目（RDH2021-01）

作者(Author): 刘健,王岚,孙浩宁

参考文献(References)：

• [1] Muntner P, Carey RM, Gidding S, et al. Potential U.S.population impact of the 2017 ACC/AHA high blood pressure guideline[J]. J Am Coll Cardiol, 2018, 71(2):109-118.
• [2] Krum H, Schlaich M, Whitbourn R, et al. Catheterbased renal sympathetic denervation for resistant hypertension:a multicentre safety and proof-of-principle cohort study[J].Lancet, 2009, 373:1275-1281.
• [3] Symplicity HTN-2 Investigators. Renal sympathetic denervation in patients with treatment-resistant hypertension(the Symplicity HTN-2 Trial):a randomised controlled trial[J]. Lancet,2010, 376(9756):1903-1909.
• [4] Bhatt DL, Kandzari DE, O’Neill WW, et al. A controlled trial of renal denervation for resistant hypertension[J]. N Engl J Med, 2014, 370:1393-1401.
• [5]王捷. 2021年欧洲高血压学会关于经导管去肾交感神经术立场文件的解读：经导管去肾交感神经术真的要来了[J]，中国介入心脏病学杂志，2021,29(10):554-557.
• [6] Bradford JR. The innervation of the renal blood vessels[J]. J Physiol,1889,10:358-432.18.
• [7] Bertog SC, Sobotka PA, Sievert H. Renal denervation for hypertension[J]. JACC Cardiovasc Interv, 2012, 5(3):249-258.
• [8] B?hm M, Kario K, Kandzari DE, et al. E ffi cacy of catheterbased renal denervation in the absence of antihypertensive medications(SPYRAL HTN-OFF MED Pivotal):a multicentre, randomised, sham-controlled trial[J]. Lancet,2020, 395(10234):1444-1451.
• [9] Ogoyama Y, Tada K, Abe M, et al. Ef fects of renal denervation on blood pressures in patients with hypertension:a systematic review and meta-analysis of randomized sham-controlled trials[J].Hypertens Res,2022, 45(2):210-220.
• [10] Yang X, Liu H, Chen S, et al. Intravascular renal denervation reduces ambulatory and office blood pressure in patients with essential hypertension:a meta-analysis of randomized shamcontrolled trials[J]. Kidney Blood Press Res,2022, 47(6):363-374.
• [11] Ahmad Y, Francis DP, Bhatt DL, et al. Renal denervation for hypertension:a systematic review and meta-analysis of randomized, blinded, placebo-controlled trials[J]. JACC Cardiovasc Interv,2021, 14(23):2614-2624.
• [12] Mahfoud F, Kandzari DE, Kario K, et al. Long-term e ffi cacy and safety of renal denervation in the presence of antihypertensive drugs(SPYRAL HTN-ON MED):a randomised, shamcontrolled trial[J]. Lancet, 2022, 399(10333):1401-1410.
• [13] Azizi M, Daemen J, Lobo MD, et al. 12-month results from the unblinded phase of the RADIANCE-HTN SOLO trial of ultrasound renal denervation[J]. JACC Cardiovasc Interv,2020, 13(24):2922-2933.
• [14] Ott C, Mahfoud F, Mancia G, et al. Renal denervation in patients with versus without chronic kidney disease:results from the Global SYMPLICITY Registry with follow-up data of 3 years[J].Nephrol Dial Transplant, 2022, 37(2):304-310.
• [15] Mahfoud F, Bloch MJ, Azizi M, et al. Changes in blood pressure after crossover to ultrasound renal denervation in patients initially treated with sham in the RADIANCE-HTN SOLO trial[J].Euro Intervention, 2021, 17(12):e1024-e1032.
• [16] Bazoukis G, Thomopoulos C, Tse G, et al. Impact of renal sympathetic denervation on ardiac magnetic resonance-derived cardiac indices in hypertensive patients-A meta-analysis[J]. J Cardiol,2021, 78(4):314-321.
• [17] B?hm M, Tsioufi s K, Kandzari DE, et al. Ef fect of heart rate on the outcome of renal denervation in patients with uncontrolled hypertension[J]. J Am Coll Cardiol,2021, 78(10):1028-1038.
• [18] Kario K, Yokoi Y, Okamura K, et al. Catheterb a s e d ultrasound renal denervation in patients with resistant hypertension:the randomized, controlled REQUIRE trial[J].Hypertens Res,2022, 45(2):221-231.
• [19] Kim BK, Kim HS, Park SJ, et al. Long-term outcomes after renal denervation in an Asian population:results from the Global SYMPLICITY Registry in South Korea(GSR Korea)[J].Hypertens Res, 2021, 44(9):1099-1104.
• [20] Weber T, Wassertheurer S, Mayer CC, et al. Twenty-fourhour pulsatile hemodynamics predict brachial blood pressure response to renal denervation in the SPYRAL HTN-OFF MED Trial[J]. Hypertension,2022, 79(7):1506-1514.
• [21] Fisher NDL, Kirtane AJ, Daemen J, et al. Plasma renin and aldosterone concentrations related to endovascular ultrasound renal denervation in the RADIANCE-HTN SOLO trial[J]. J Hypertens, 2022, 40(2):221-228.
• [22] Kandzari DE, Hickey GL, Pocock SJ, et al. Prioritised endpoints for device-based hypertension trials:the win ratio methodology[J]. EuroIntervention, 2021, 16(18):e1496-e1502.
• [23] Schmieder RE, Kandzari DE, Wang TD, et al. Dif ferences in patient and physician perspectives on pharmaceutical therapy and renal denervation for the management of hypertension[J]. J Hypertens, 2021, 39(1):162-168.