Radiofrequency renal denervation
Topic Status Complete
Renal denervation to treat people with resistant hypertension
Summary
The HTW Assessment Group considered the evidence presented in Evidence Appraisal Report 042. They were also aware of recent interventional procedure guidance covering renal denervation from the National Institute for Health and Care Excellence (NICE IPG754). The guidance recommends that the procedure should be used with ‘special arrangements for clinical governance, consent, and audit or research’.
Given that NICE IPG754 did not recommend that the procedure could be used with standard arrangements, the Assessment Group concluded that it would not appropriate for the HTW Appraisal Panel to produce Guidance. The Assessment Group recommended publication of the appraisal as an Evidence Appraisal Report only.
Why was this topic appraised?
High blood pressure (hypertension) is an important, treatable cause of premature morbidity and mortality. It is a major risk factor for stroke, myocardial infarction, heart failure, chronic kidney disease, cognitive decline, and premature death. Lifestyle changes, smoking cessation, and diet modification, play an important role in supporting people with hypertension to manage their blood pressure. There are also several medications that can be used to help control blood pressure.
For some people, these approaches are not sufficient to reduce hypertension to acceptable levels. This type of hypertension is referred to as resistant hypertension and the risk of negative outcomes is high for this population. For this population, NICE recommends that adherence to medication and home blood pressure is explored and if needed, addition of further medication and referral to specialist services may be needed. Additional treatments may therefore be beneficial.
Plain language summary
High blood pressure (hypertension) is a condition in which the force of the blood flow against artery walls is high enough that it may eventually cause health problems, such as heart disease. It is a major risk factor for stroke, heart failure, chronic kidney disease, cognitive decline, and premature death. It is therefore important to help people maintain a healthy blood pressure.
There are a number of medications that can be used to help control blood pressure, as well as implementing lifestyle changes. However, for some people, this isn’t enough to bring their blood pressure to healthy level. This is known as resistant hypertension.
Renal denervation therapy uses radiofrequency ablation, which is an image-guided technique that uses heat to destroy cells. The nerves in the renal arteries are burned to cause a reduction in the nerve activity, which decreases blood pressure. The procedure is minimally invasive and is usually carried out under local anaesthetic.
Health Technology Wales looked for evidence on renal denervation to treat people with resistant hypertension.
Topic Exploration Report
TER316 12.2021
Evidence Appraisal Report
EAR042 12.2023
Health Technology Wales Partners
