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Bhatt DL, Kandzari DE, O’Neill WW, D’Agostino R, Flack JM, Katzen BT. A controlled trial of renal denervation for resistant hypertension. N Engl J Med. 2014;370(15):1393–401. In this large US randomised trial including a sham procedure, the benefit assignable to renal denervation was < 3 mmHg, vs. 25–30 mmHg in Symplicity HTN-2 and other previous studies. The main explanation accounting for this large discrepancy is blinding, which minimized patient- and physician-related biases in Symplicity HTN-3. The failure of Symplicity HTN-3 to meet its primary endpoint showed unequivocally that renal denervation is not ready for wide clinical dissemination.
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