Treatment-resistant hypertension (TRH) is diagnosed when blood pressure remains above 140/90 mmHg systolic/diastolic despite lifestyle changes and the use of at least three antihypertensive agents at maximum tolerated doses. Renal denervation (RDN) is a minimally invasive procedure in which the sympathetic nerves along the renal artery are obliterated to lower blood pressure.

A total of ten RCTs comparing RDN with sham therapy were included to assess the efficacy and safety of RDN. Overall, the current evidence suggests that RDN is effective in lowering blood pressure for up to six months after the intervention and is relatively safe. It remains unclear however, which patients benefit most from RDN and how long the blood pressure-lowering effect persists.