Management of resistant hypertension remains a vexing barrier to reducing cardiovascular risk, and emerging procedural options like renal denervation coupled with data on sex-specific treatment responses demand a shift toward more personalized strategies.
Chronic, uncontrolled hypertension despite multidrug regimens affects an estimated 10–20% of treated patients, typically those on three or more antihypertensive medications, driving excess risk of stroke, myocardial infarction, and renal failure. Renal denervation, which targets renal sympathetic nerves to blunt aberrant neurohormonal signals, has re-emerged as a key treatment option for resistant hypertension following FDA approval in 2023 and recent device and procedural refinements. Clinicians can explore detailed insights on patient selection and referral to identify patients most likely to benefit from this advanced hypertension management approach.
Defining patient selection criteria for renal denervation is central to maximizing benefit; candidates typically present with office systolic blood pressure above 140 mm Hg and diastolic blood pressure above 90 mm Hg despite three or more antihypertensive agents, including a diuretic, alongside confirmed adherence and exclusion of secondary causes. Shared decision-making between primary care and hypertension specialists can streamline timely referral: as noted in the earlier report, patients should be referred once medication optimization and adherence support have failed to achieve control, rather than delaying procedural evaluation until end-organ damage accrues.
Beyond device-based therapies, understanding sex differences in cardiovascular treatment responses is reshaping personalized medicine approaches. A recent investigation of sex differences in treatment outcomes demonstrated that women with aortic valve stenosis often present at an older age and derive distinct benefits from transcatheter versus surgical valve replacement compared with men. Recognizing these nuances enhances procedural planning and long-term management, ensuring that female and male patients alike receive therapies aligned with their specific patient profiles.
Integrating both renal denervation for resistant hypertension and sex-specific insights into cardiovascular treatment protocols supports a trajectory toward truly individualized care. As device safety profiles improve and registries expand, clinicians should weigh potential complications such as renal artery injury and bleeding, known limitations, and cost implications before considering these modalities early in the care continuum for hard-to-treat populations.
- The integration of renal denervation offers a promising solution for patients with resistant hypertension unresponsive to medication.
- Timely referral for renal denervation requires collaborative decision-making between primary and specialty care.
- Sex differences in treatment outcomes are increasingly recognized as crucial for tailoring personalized cardiovascular therapies.
- The evolving understanding of these factors is setting the stage for more effective, individualized patient care strategies.