Renal Denervation: A Multicenter, Real-World Experience

Abstract

Background: Renal denervation (RDN) has emerged as a promising device-based therapy for the management of resistant hypertension (RH). However, real-world evidence of effectiveness and safety in the Indian population remains limited. This study aimed to evaluate the efficacy and safety of catheter-based RDN in reducing blood pressure (BP) and antihypertensive medication burden among Indian patients with RH.

Methods: This retrospective, multicenter, real-world study included 26 consecutive patients who underwent RDN across 21 tertiary care centers in India. Patients were followed at discharge and at 1, 3, 6, and 12 months after the procedure. The primary endpoint was the change in office BP at 12 months. Secondary endpoints included changes in antihypertensive medication burden and procedure-related safety outcomes.

Results: The mean age of the study population was 60.7 ± 13.8 years, and 61.5% were male. Baseline systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 186.2 ± 18.8 and 98.7 ± 25.3 mm Hg, respectively. Significant reductions in BP were observed at all follow-up time points. At 12 months, mean SBP and DBP decreased to 121.7 ± 10.5 and 75.9 ± 4.7 mm Hg, corresponding to reductions of 63.4 and 24.7 mm Hg, respectively (both P < 0.001). The mean number of antihypertensive medication classes was significantly reduced from 5.12 ± 1.70 at baseline to 2.00 ± 0.80 at 1 year (P < 0.001). No major periprocedural complications or adverse events were reported. One patient experienced an access-site vascular complication involving the superficial femoral artery, which was successfully managed with covered stent implantation without further sequelae.

Conclusions: RDN was associated with significant and sustained reductions in BP and antihypertensive medication burden over 12 months. The procedure demonstrated a favorable safety profile, supporting its role as an as a safe and effective adjunctive treatment option for patients with RH.