The American College of Cardiology (ACC) and American Heart Association (AHA) have updated their 2025 hypertension guidelines to include renal denervation (RDN) as a treatment option for patients with resistant or uncontrolled high blood pressure. Published in JACC, Circulation, and Hypertension, the guidelines grant RDN a Class IIb recommendation, recognizing it as an adjunct to lifestyle modifications and medications.
This move follows earlier support from European medical societies and highlights FDA-approved devices such as Medtronic’s Symplicity Spyral radiofrequency system and ReCor Medical’s Paradise ultrasound system—the first to receive FDA clearance. Both technologies work by disrupting overactive renal nerves to achieve sustained blood pressure reduction.
The guidelines recommend RDN for adults whose blood pressure remains above target despite medication, particularly those with readings ≥140/90 mm Hg, while excluding pregnant patients and those with significant renal artery narrowing.
Medtronic emphasized that the update validates RDN as an additional option, citing its SPYRAL HTN program showing durable reductions over three years. ReCor highlighted the strength of randomized, sham-controlled RADIANCE trials, noting that the inclusion of RDN reflects objective evidence across diverse populations.
Experts see the update as a pivotal step in integrating RDN into treatment pathways, especially for stage 2 hypertension patients intolerant to further medications. With hypertension affecting 1.28 billion people globally and most lacking adequate control, the endorsement of RDN could expand access to this promising intervention worldwide.