简介：Overthepastdecade,percutaneousrenaldenervationhasbeenvigorouslyinvestigatedasatreatmentforresistanthypertension.TheSYMPLICITYradiofrequencycathetersystem(MedtronicCardioVascularInc.,SantaRosa,CA,USA)isthemosttesteddeviceinclinicaltrials.AfterthepositiveresultsofsmallphaseIandIIclinicaltrials,SYMPLICITYHTN-3(aphaseIII,multi-center,blinded,sham-controlledrandomizedclinicaltrial)wascompletedin2014,butdidnotshowsignificantbloodpressureloweringeffectwithrenaldenervationcomparedtomedicaltherapyandcausedtheinvestigatorsandindustrytorevisitboththebasicscienceelementsofrenaldenervationaswellasthedesignofrelatedclinicaltrials.ThisreviewsummarizestheSYMPLICITYtrials,analyzestheSYMPLICITYHTN-3data,andprovidesinsightsgainedfromthistrialinthedesignofthemostrecentclinicaltrial,theSPYRALHTNGlobalclinicaltrial.Otherthanhypertension,theroleofrenaldenervationinthemanagementofotherdiseaseprocessessuchassystolicanddiastolicheartfailure,metabolicsyndrome,arrhythmia,andobstructivesleepapneawiththecommonpathophysiologicpathwayofsympatheticoveractivityisalsodiscussed.