2024 ESC Guidelines

The following addresses health care professionals only. Conclusions and considerations have to be checked by reading the scientific references given below:

One year after the updated ESH guidelines were published, the ESC followed suit today, on Friday, August 30th, 2024, by releasing the 2024 ESC Guidelines for the management of elevated blood pressure and hypertension (HT). In these guidelines, Renal Denervation (RDN) "can be considered as a treatment option in patients with an eGFR >40 ml/min/1.73m² who have uncontrolled blood pressure (BP) despite the use of antihypertensive drug combination therapy, or if drug treatment causes serious side effects and poor quality of life." Eligible patients must have "true resistant HT," where medication adherence has been confirmed by lab testing and various causes of secondary hypertension have been excluded. This applies to 5% of all patients with HT – a significant number, given that HT affects one-third of the population. The ESC guidline commitee merits the potential cost-effectiveness of RDN in patients at "very high risk of cardiovascular death (CVD) events and who have uncontrolled BP due to resistant HT (with or without non-adherence)".

The average BP-lowering effect of renal denervation in the entire study population appears to be that of a standard BP-lowering medication. With the introduction of the Paradise™ Ultrasoundultrasound-based RDN, the interventional burden has been significantly reduced to 7 seconds of energy delivery at each of 4-6 sites in the main renal artery or side branches, with up to 6mm lesion depth and parallel cooling that protects the inner lumen of the renal artery.