Renal denervation in cardiometabolic disease: concepts, achievements and perspectives

Aims: Growing evidence suggests that renal denervation may reduce elevated blood pressure values in resistant hypertension. More recently a number of studies have assessed the effects of the intervention on the dysmetabolic disarray (i.e. insulin resistance, glucose intolerance, and diabetes mellitus) frequently detectable in resistant hypertensive patients. The present viewpoint article critically examines the results obtained so far in this area. Data synthesis: The results of the studies performed so far provide evidence that ablation of efferent and afferent sympathetic renal nerves improves glucose metabolism, reducing the incidence of glucose intolerance, fasting hyperglycemia and diabetic state in resistant hypertensive patients. The results, however, cannot be regarded as conclusive, taking into account that limitations in the experimental design of the studies published so far, as well as the frequent lack of specific subgroups data analysis, prevent to draw conclusive information on this issue. Conclusions: Although promising, the favorable results of renal denervation on the metabolic disarray frequently detectable in resistant hypertension require to be confirmed in large scale, randomized studies which are currently ongoing.