2023 Philippine Working Group Consensus Statement on Renal Denervation Therapy for the Management of Hypertension
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Philippine Renal Denervation Consortium Group
Raymond Oliva, MD*,† | Deborah Ignacia D. Ona, MD MBA*,†,‡,§ | Lourdes Ella G. Santos, MD*,†,‖ | Felix Eduardo Punzalan, MD*,†,‖ | John David Tan, MD*,‡,§ | Gilbert Villela, MD*,‖,¶ | Benjamin Balmores, MD*,‡,§ | Krizia Camille Yap-Uy, MD§,‖ | Roberta Maria Cawed-Mende, MD§,‖,¶ | Jose Nicholas Cruz, MD*,‖,‡
*Philippine Society of Hypertension, Pasig; †Department of Medicine, University of the Philippines–Philippine General Hospital, Manila; ‡St Luke’s Medical Center, Bonifacio Global City, Taguig; §St Luke’s Medical Center, Quezon City; ‖Philippine Heart Association, Pasig; and ¶Philippine Heart Center, Quezon City, Philippines
Correspondence:
Raymond Oliva, MD
Email: drrayms@gmail.com
Statement of Intent: This consensus statement is meant for the clinical management of hypertension using device based-therapies, based on the best available evidence at the time of its development, and is designed to be a guide for clinicians in managing hypertension for the Filipino patient. This, however, should not replace sound clinical judgment by doctors, and the ultimate decision for treatment should involve both the clinician and the patient.
These guidelines issued in June 2023 will be reviewed if significant new evidence becomes available.
Funding: These guidelines were jointly funded by the Philippine Society of Hypertension and the Philippine Heart Association, and these organizations did not influence the development of the recommendations.
CPG Secretariat
Philippine Society of Hypertension and Philippine Heart Association
Electronic version is available on the following websites:
https://www.philippinesocietyofhypertension.org.ph
http://www.philheart.org
- Sison J, Cawed-Mende RM, Oliva RV. Prevalence, awareness, and treatment profile of adult Filipino hypertensive individuals: Philippine Heart Association– Council on Hypertension Report on Survey of Hypertension (PRESYON-4). Philipp J Cardiol 2021:53–68.
- Sy RG, Morales DD, Dans AL, Paz-Pacheco E, Punzalan FE, Abelardo NS, Duante CA. Prevalence of atherosclerosis-related risk factors and diseases in the Philippines. J Epidemiol 2012;22(5):440–447.
- Ona D, Jimeno CA, Jasul GV, et al. Executive summary of the 2020 clinical practice guidelines for the management of hypertension in the Philippines. J Clin Hypertens 2021;23(9):1637–1650.
- Guillaume L, Artifoni M, Daniel M, Barber-Chamox D. Resistant hypertension: novel insights. Curr Hypertens Rev 2020;16(1):61-72.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/ AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/ PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018;71(6):e13–e115.
- Carey RM, Calhoun D, Bakris G, et al. Resistant hypertension: detection, evaluation, and management. A scientific statement from the American Heart Association. Hypertension 2018;72:e59–e90.
- Smith PA, Graham LN, Mackintosh AF, Stoker JB, Mary DA. Relationship between central sympathetic activity and stages of human hypertension. Am J Hypertens 2004;17(3):217–222.
- Schlaich MP, Sobotka PA, Krum H, Lambert E, Esler MD. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med 2009;361(9):932–934.
- Azizi M, Sapoval M, Gosse P, et al. Optimum and stepped care standardized antihypertensive treatment with or without denervation for resistant hypertension (DENERHTN): a multicentre, open-label, randomized controlled trial. Lancet 2015;385(9981):1957–1965.
- Desch S, Okon T, Heinemann D, et al. Randomized sham controlled trial of renal sympathetic denervation in mild resistant hypertension. Hypertension 2015;65:1202–1208.
- Rosa J, Widimsky P, Tousek P, et al. Randomized comparison of renal denervation versus intensified pharmacotherapy including spironolactone in true-resistant hypertension. Hypertension 2015;65: 407–413.
- Esler M, Krum H, Schlaich M, et al, for the SYMPLICITY HTN-2 Investigators. Renal sympathetic denervation for treatment of drug-resistant hypertension. One-year results from the SYMPLICITY HTN-2 randomized controlled trial. Circulation 2012;126: 2976–2982.
- Bakris G, Townsend R, Liu M, et al for the SYMPLICITY HTN-3 Investigators. Impact of renal denervation on 24-hour ambulatory blood pressure. J Am Coll Cardiol 2014;64:1071–1078.
- Townsend R, Mahfoud F, Kandzari D, et al, on behalf of the SPYRAL HTN-OFF Med Trial Investigators. Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF) a randomized, sham-controlled, proof-of concept trial. Lancet 2017;390:2160–2170.
- Kandzari DE, Bhm M, Mahfoud F, et al, on behalf of the SPYRAL HTN-ON MED Trial Investigators. Effect of renal denervation in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN-ON MED proof-of-concept randomized trial. Lancet 2018;391(10137):2346–2355.
- Azizi M, Schmieder R, Mahfoud F, et al, on behalf of the RADIANCE-HTN Investigators. Endovascular ultrasound renal denervation to treat hypertension (RADIANCE-HTN SOLO): a multicentre, international, single-blind, randomized, sham-controlled trial. Lancet 2018;6736(18);1–11.
- Coppolino G, Pisano A, Rivoli L, Bolignano D. Renal denervation for resistant hypertension. Cochrane Database Syst Rev 2017;2:CD011499.
- Stavropoulos K, Patoulias D, Imprialos K, et al. Efficacy and safety of renal denervation for the management of arterial hypertension: a systematic review and meta-analysis of randomized, sham-controlled, catheter-based trials. J Clin Hypertens 2020;22:572–584.
- Mahfoud F, Bohm M, Aziz M, et al. Proceedings from the European Clinical Consensus Conference for Renal Denervation: considerations on future clinical design. Eur Heart J 2015;36(33):2219–2227.
- Ahmad Y, Kane C, Arnold A, et al. Randomized blinded placebo-controlled trials of renal sympathetic denervation for hypertension: a meta-analysis. Cardiovasc Revasc Med 2022;34:112–118.
- Agasthi P, Shipman J, Arsanjani R, et al. Renal denervation for resistant hypertension in the contemporary era: a systematic review and meta-analysis. Sci Rep 2019;9:6200.
- Azizi M, Saxena M, Wang Y, for the RADIANCE II Investigators. Endovascular ultrasound renal denervation to treat hypertension: the RADIANCE II randomized clinical trial. JAMA 2023;329 (8):651–661.
- Bohm M, Mancia G, Schmieder M, Schlach M, Mahfoud F. Global SYMPLICITY Registry: 3 year safety and efficacy data. Hypertension 2017;70(1):A092.
- Kario K, Ogawa H, Okumura K, Okura T, on behalf of the SYMPLICITY HTN-Japan Investigators. SYMPLICITY HTN Japan—first randomized controlled trial of catheter-based renal denervation in Asian patients. Circ J 2015;79:1222– 1229.
- Chin Chia Y, Ahmad W, Fong A, et al. 2022 Malaysian Working Group consensus statement on denervation for management of arterial hypertension. Hypertens Res 2022;45:1111–1122.
- Dorenkamp M, Bonaventura K, Leber A, et al. Potential lifetime cost-effectiveness of catheter-based renal sympathetic denervation in patients with resistant hypertension. Eur Heart J 2013;34:451–461.
- Chowdhury E, Reid C, Zomer E, et al. Cost effectiveness of renal denervation therapy for treatment-resistant hypertension: a best case scenario. Am J Hypertens 2018;31(10):1156–1163.
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