Renal Denervation for Hypertension Makes a Tentative Comeback

The advent of catheter-based renal denervation held the promise of a procedure-based approach to resistant hypertension. The sham-controlled clinical trial, Symplicity HTN-3, showed no advantage for the technique, although proponents suggested that procedural issues might have compromised the study. Subsequent small trials hinted that denervation might work. Researchers have now reported findings from the manufacturer-funded, randomized, sham-procedure–controlled SPYRAL HTN-OFF MED (SPYRAL Pivotal; NCT02439749) trial, performed at 44 international sites among people who had an office-based systolic pressure of 150 to 180 mm Hg. The primary endpoint was the baseline-adjusted change in the 24-hour systolic pressure at 3 months. Participants d…