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Review
. 2025 Oct 10.
doi: 10.1007/s40119-025-00434-4. Online ahead of print.

Resistant Blood Pressure: New Frontiers in Interventional Hypertension Therapy

Jeffrey D Taylor  1 , Chukwunonyelum Uche  2 , Vanessa Rowe  2 , Aleyah Hattab  2 , Arvind Draffen  2 , Vicki Groo  2 , Adhir Shroff  2
Affiliations
Review

Resistant Blood Pressure: New Frontiers in Interventional Hypertension Therapy

Jeffrey D Taylor et al. Cardiol Ther. .

Abstract

Hypertension remains a leading global health challenge, affecting over 1.3 billion individuals worldwide and contributing significantly to cardiovascular morbidity and mortality. In recent years, interventional device-based therapies have emerged as promising adjuncts by targeting sympathetic overactivity and autonomic dysregulation, key mechanisms in the pathogenesis of hypertension. Currently, the use of these interventional therapies is primarily reserved for patients with resistant hypertension (RH) who remain uncontrolled despite optimal medical therapy. This review provides an overview of the evolving landscape of interventional approaches, including renal denervation (RDN), baroreceptor activation therapy (BAT), carotid body modulation, hepatic denervation, and cardiac neuromodulation. Among these, RDN has the most robust clinical trial evidence, while other neuromodulatory strategies are being evaluated in early-phase studies. Additionally, this review underscores the importance of systematically identifying and managing secondary causes of hypertension, such as primary aldosteronism, renovascular disease, and obstructive sleep apnea, before considering procedural interventions. As the field advances, these therapies may assume a more prominent role in precision-based hypertension management.

Keywords: Baroreceptor activation; Endovascular therapy; Interventional cardiology; Interventional therapy; Renal denervation; Resistant hypertension; Secondary hypertension.

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Conflict of interest statement

Declarations. Conflict of Interest: Vicki Groo, Vanessa Rowe – Medtronic – Consulting. Jeffrey D. Taylor, Adhir Shroff, Chukwunonyelum Uche, Aleyah Hattab, and Arvind Draffen have nothing to disclose. Ethical Approval: This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

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