Shaping the future of renal denervation-the relevance of sham-controlled randomized trials and recent meta-analyses

The overall prevalence of hypertension in adults globally is estimated to be 30–45% with even higher rates of >60% in people aged above 60 years (1). It is expected that the number of people with hypertension will further grow by 15% to 20% and reach ~1.5 billion in 2025 (2). A systolic blood pressure (BP) ≥140 mmHg contributes substantially to the mortality and disability burden (70%), mostly related to ischemic and hemorrhagic stroke (1.5 and 2 million, respectively), and ischemic heart disease (4.9 million) (3). While lifestyle modification and antihypertensive (AH) pharmacotherapy are highly effective in reducing elevated BP, many patients remain uncontrolled due to a variety of reasons including non-adherence and non-compliance, intolerance to prescribed drugs, or true treatment resistance. Some of these patients may benefit from novel interventional procedures such as catheter-based renal denervation (RDN) as a suitable alternative.