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    Alcohol-mediated perivascular renal sympathetic denervation for resistant hypertension

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    1 Draft recommendations

    1.1

    More research is needed on alcohol-mediated perivascular renal sympathetic denervation for resistant hypertension.

    1.2

    This procedure should only be done as part of a formal research study and a research ethics committee needs to have approved its use.

    More research

    1.3

    More research, in the form of adequately powered randomised controlled trials, is needed on:

    • patient selection

    • the number and types of antihypertensive medicine use and medication adherence

    • the effect of optimising antihypertensive medicines and other factors, such as lifestyle change

    • the effect on blood pressure and duration of any effect

    • quality of life (qualitative and quantitative outcomes)

    • complications.

    Why the committee made these recommendations

    The evidence for this procedure is limited. It does not show major safety concerns but this is based on limited evidence and needs confirming, because this procedure is invasive and has potential complications. There is also uncertainty about how well the procedure reduces blood pressure and how long this would last because of the considerable placebo effect. This effect refers to a beneficial effect that is seen in a study even when no active treatment has been given. The reductions in blood pressure may have also been affected by the Hawthorne effect, which is when people change their behaviour because they are taking part in a study. For example, people may have taken their antihypertensive medicines correctly and changed their lifestyles. So, more research is needed to better understand the procedure's benefits and complications, and which people would benefit from it.