- The European Society of Hypertension (ESH) updated its guidelines in late June on the treatment of high blood pressure to offer some support for the use of renal denervation.
- In the new guidelines, the ESH assigns a Class II recommendation to the use of renal denervation in patients with resistant hypertension, indicating that “there is no general consensus or only doubtful evidence.”
- Medtronic, which is competing with ReCor Medical for the nascent market, hailed the updated guidelines on Monday as a “turning point” for the use of renal denervation in treating high blood pressure.
In 2018, the ESH published guidelines that said evidence for renal denervation was “conflicting” and recommended against its routine use in the treatment of high blood pressure. However, subsequent studies by ReCor and Medtronic led the ESH to publish a position paper in 2021 that was more supportive of the treatment.
The position paper has informed updated guidelines. In the 2023 guidelines, the ESH provides a Class II recommendation that renal denervation can be considered as a treatment option in patients with certain characteristics. The Class II recommendation indicates that there is still some debate about the use of renal denervation but is an upgrade on the warning against using the procedure outside of trials that the ESH issued in 2018.
Jason Weidman, president of Medtronic’s coronary and renal denervation business, welcomed the new guidelines, framing them as reinforcing the use of renal denervation as a third treatment pillar alongside lifestyle changes and medicines.
“This is a positive step forward for the Symplicity Blood Pressure Procedure and underscores the desire of the clinical community to include new treatment options to improve hypertension control rates,” Weidman said in a statement.
The ESH also issued strong, Class I recommendations on how and when renal denervation should be used, voicing support for selecting patients based on a shared decision-making process and limiting the procedure to “experienced specialized centers.”