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Effects of Renal Denervation on Sympathetic Nervous System Activity

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Interventional Therapies for Secondary and Essential Hypertension

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

Prior to the emergence of percutaneous radiofrequency-based therapy for renal denervation, considerable preclinical and clinical experience reinforced the importance for afferent and efferent renal sympathetic nerve activity in the initiation and maintenance of hypertension and other cardiovascular diseases. The role of the adrenergic tone is also supported by the evidence of an increased renal norepinephrine spillover to plasma in resistant hypertensives – a biomarker of increased renal sympathetic activation. The observation that surgical renal sympathectomy improved blood pressure control has led to the considerations of a percutaneous approach to renal sympathetic denervation. The rapid evolution in our understanding of both the human renal nerve microanatomy and the ideal technique for the safe application of radiofrequency technology leads to successful renal nerve ablation in previous trials on resistant hypertension and for future studies in pathophysiological conditions characterized by an hyperadrenergic tone.

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Abbreviations

BP:

Blood pressure

HTN:

Hypertension

NTS:

Nucleus tractus solitarius

RDN:

Renal denervation

SNS:

Sympathetic nervous system

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Author information

Authors and Affiliations

  1. Cardiologia, Ospedale San Luca, IRCCS Istituto Auxologico Italiano, Milan, Italy

    Gino Seravalle

  2. Clinica Medica, Dipartimento di Scienze della Salute, Università Milano-Bicocca, Via Pergolesi 33-20052, Monza, Italy

    Gianmaria Brambilla & Guido Grassi

Authors
  1. Gino Seravalle
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  2. Gianmaria Brambilla
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  3. Guido Grassi
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Corresponding author

Correspondence to Guido Grassi .

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Editors and Affiliations

  1. First Cardiology Clinic, National and Kapodistrian University of Athens, Athens, Greece

    Costas Tsioufis

  2. Department of Nephrology and Hypertension, University Hospital Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

    Roland E. Schmieder

  3. IRCCS Istituto Auxologico Italiano, University Milano-Bicocca, Milano Monza, Italy

    Giuseppe Mancia

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Seravalle, G., Brambilla, G., Grassi, G. (2016). Effects of Renal Denervation on Sympathetic Nervous System Activity. In: Tsioufis, C., Schmieder, R., Mancia, G. (eds) Interventional Therapies for Secondary and Essential Hypertension. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-34141-5_20

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