Renal Denervation: A Promising Alternative for Medications to Ameliorate the Physical and Mental Burden of Hypertension, A Narrative Review

Abstract

: Hypertension is the most significant modifiable risk factor for cardiovascular disease (CVD) and is associated with substantial negative effects on both individual and societal levels. Renal denervation (RDN) has been established as a safe and effective medical intervention for treating resistant hypertension, with approval from the Food and Drug Administration and endorsement by guidelines such as those of the European Society of Cardiology (2023) and the American Heart Association. However, with the advent of various types of RDN methods, including radiofrequency-, ultrasound-, and alcohol-based techniques, debates have intensified regarding their comparative efficacy and safety. Additionally, researchers have expanded their focus to consider outcomes beyond hypertension management. Most studies have demonstrated that this non-pharmacologic treatment significantly improves systolic and diastolic 24-hour ambulatory and office blood pressure in both the short- and long-term. Despite these findings, the social and psychological impacts of RDN on a broader scale have been less frequently discussed. Given the high burden of hypertension and its complications, such as cardiovascular and cerebrovascular events, this intervention could substantially enhance the quality of life and mental health of affected populations. Non-adherence to antihypertensive medications remains a critical challenge, driven by factors such as side effects, pregnancy, financial constraints, psychiatric disorders, and polypharmacy with its associated consequences. Renal denervation, by improving blood pressure control, offers the potential to enhance quality of life and reduce the incidence of severe physical and mental health conditions. This study provides a comprehensive perspective on this advanced treatment, emphasizing its impact on individual and societal well-being, physical health, and mental health.