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In 2009, NEJM Journal Watch covered one of the first published studies of renal denervation (RDN) as a potential treatment for hypertension (NEJM JW Cardiol May 2009 and Lancet 2009; 373:1275). Many clinicians might not realize that in late 2023, fully 15 years later, the U.S. FDA finally approved two RDN systems as “adjunctive treatment in hypertension patients in whom lifestyle modifications and antihypertensive medications do not adequately control blood pressure.” These catheter-based systems diminish renal sympathetic nerve activity through ultrasound (the Paradise system) or radiofrequency (the Symplicity system) ablation; the renal arteries are accessed via a femoral artery…