2024 European Society of Cardiology Guidelines
ESC Guidelines recommend renal denervation
for uncontrolled and resistant hypertension patients.1
The European Society of Cardiology now includes renal denervation (RDN) as a class IIb recommendation that provides a safe and effective complementary care option to control blood pressure.1
Uncontrolled hypertension
With increased CV risk and treated with <3 antihypertensive drugs
Resistant hypertension
Treated with ≥3 antihypertensive drugs including diuretic
Patients should also have:
eGFR ≥40 ml/min/1.73m2
Express a preference for RDN in a shared-decision making process
Additional recommendations
Selection of patients should be done after assessment by a multidisciplinary team.
Procedure should be performed in experienced medium to high volume centers.
Hot from 2024 ESC congress: Prof. A. Pathak and Prof. S.Brouwers comment the new ESC guidelines. Watch now.
Elevate your hypertension care options
Renal denervation: the third pillar for hypertension management.
Lifestyle
modification
Medication
Renal
denervation
Symplicity™ blood pressure procedure
With over 30,000 real-world RDN patients, Medtronic Symplicity™ blood pressure procedure has already proven to deliver clinically significant, safe, and sustained BP reductions in multiple clinical trials.2–7
> 9 mmHg
mean reduction in OSBP in patients off
and on medications2,3
Access the full publication of the 2024 ESC Guidelines for the management of elevated blood pressure and hypertension, available on the European Heart Journal. Renal denervation section from page 55.
2023 European Society of Hypertension (ESH) Guidelines also recommend renal denervation for uncontrolled hypertension patients.8
1. McEvoy JW. et al, European Heart Journal, ehae178, https://doi.org/10.1093/eurheartj/ehae178
2. Böhm M, Kario K, Kandzari DE, et al. Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. Lancet. 2020;395(10234):1444–1451. doi: 10.1016/S0140-6736(20)30554-7.
3. Kandzari DE, Townsend RR, Kario K, et al. Safety and efficacy of renal denervation in patients taking antihypertensive medications. J Am Coll Cardiol. 2023;82(19):1809–1823. doi: 10.1016/j.jacc.2023.08.045.
4. Mahfoud F, Kandzari DE, Kario K, et al. Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial. Lancet. 2022;399(10333):1401–1410. doi: 10.1016/S0140-6736(22)00455-X.
5. Mahfoud F, et al. Outcomes following radiofrequency renal denervation according to antihypertensive medications: subgroup analysis of the Global SYMPLICITY Registry DEFINE. Presented at EuroPCR 2023, Paris, France.
6. Mahfoud F, Mancia G, Schmieder RE, et al. Outcomes following radiofrequency renal denervation according to antihypertensive medications: Subgroup analysis of the Global SYMPLICITY Registry DEFINE. Hypertension. 2023;80(8):1759–1770. doi: 10.1161/HYPERTENSIONAHA.123.21283.
7. Medtronic data on file. RDN Catheter Historical Data, February 2025. Data includes both Symplicity Flex and Symplicity Spyral.
8. Mancia G, Kruetz R, Brunström M et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension Endorsed by the European Renal Association (ERA) and the International Society of Hypertension (ISH). J Hypertens. Published online June 21, 2023.
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