Advances In Research Of Catheter-based Renal Sympathetic Denervation (CRSD/RSD) For Treatment Of Refractory Hypertension

Hypertension is one of the most common cardiovascular diseases, and is one ofthe risk factors of other cardiovascular diseases. The treatment of high blood pressureis not as effective as once expected. Refractory hypertension is defined as bloodpressure that is above the target value, after treatment scheme three or moreantihypertensive drugs including diuretics adequately and reasonably. Because of nosuitable antihypertensive drugs, the incidence of target organ damage in patients withrefractory hypertension increased significantly, and it is of importance exploring newantihypertensive treatment method. Because of activation of the renal sympatheticnerve, hypertension was occurred and developed. So it is renal denervation that is atherapeutic strategies for hypertension. Resulting in significantly lowered bloodpressure, sympathectomy is a treatment that has increased the survival ratio of patientwith refractory hypertension. However, the subsequent side-effects and risks made itnecessary to use antihypertensive drugs. In2009, Professor Krum created firstly a newway of non-drug treatment of primary hypertension and provides a new train ofthought for the treatment of refractory hypertension by catheter-based renalsympathetic denervation(RSD) for refractory hypertension. And by basic and clinicalresearch, RSD is safe and effective. Other diseases such as left ventricular hypertrophy,chronic heart failure disease, sleep apnea syndrome, insulin resistance and chronickidney disease may also be treated by RSD. As a novel nonpharmacological therapycausing less damage, RSD has no severe complications, and a faster recovery time. However, the expertpiments should be deepening to large sample sizes, multicenterand randomized standard. This article reviews neural control of renel fuction, theneurogenic factors in hypertension, RSD and RSD in the treatment of refractoryhypertension.