Please review the posting of last week’s CPC Case here.
When you’re ready you can download the CPC Answer here.
Resistant hypertension is defined as a systolic blood pressure of 140 mmHg or higher despite at least three maximally dosed antihypertensive medications, including a diuretic. SYMPLICITY HTN-3 was a recent trial that randomized patients to renal denervation or sham procedure. The primary outcome was a change in office blood pressure by more than 5 mmHg at 6 months. Despite this lenient outcome, the renal denervation group only had a difference of -2.39 mmHg (95% CI -6.89-2.12; P=0.26 for superiority). This negative trial differs from SYMPLICITY HTN 1 and 2 (which showed a benefit of renal denervation) possibly from the placebo effect of a sham procedure.
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