Abstract

Arterial hypertension is one of the most significant and prevalent risk factors for cardiovascular disease. Despite widespread awareness of the condition, as well as a multitude of available antihypertensive drug classes, rates of uncontrolled hypertension remain high on a global scale. Frequently, poor compliance with anti-hypertensive medication plays a big role in patients’ inability to attain adequate blood pressure control. In individuals with resistant and/or uncontrolled hypertension, renal denervation is an emerging device-based therapy that has shown to be efficacious and safe in reducing blood pressure in several sham controlled trials. Additionally, it represents a treatment option for patients intolerant to oral pharmacotherapy.

University Hospital Galway has been performing renal denervation procedures over the past number of years within multicentre, international sham-controlled trials and registries. Representing a novel and emerging antihypertensive treatment option, sources of referral for renal denervation are diverse and multiple; thus, there is an unmet need for standardised referral structures in Ireland. Herein, we review current and developing referral pathways for renal denervation at our institution, and discuss streamlined patient management and requirements to establish a centre of excellence.

中文翻译：

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探索肾动脉去神经术的潜在转诊途径并在爱尔兰建立卓越中心

摘要

动脉高血压是心血管疾病最重要和最普遍的危险因素之一。尽管人们普遍认识到这种情况，并且有多种可用的抗高血压药物，但全球范围内高血压不受控制的比率仍然很高。通常，抗高血压药物依从性差是导致患者无法充分控制血压的重要原因。对于患有难治性和/或不受控制的高血压的个体，去肾神经术是一种新兴的基于设备的疗法，在多项假对照试验中已证明其在降低血压方面有效且安全。此外，它为不耐受口服药物治疗的患者提供了一种治疗选择。

过去几年，戈尔韦大学医院一直在多中心、国际假手术对照试验和登记中进行肾去神经手术。肾去神经术代表了一种新颖的、新兴的抗高血压治疗选择，其转诊来源多种多样；因此，爱尔兰对标准化转诊结构的需求尚未得到满足。在此，我们回顾了我们机构当前和正在开发的肾去神经术转诊途径，并讨论了简化的患者管理和建立卓越中心的要求。