Uncontrolled hypertension persists as an important health issue despite the availability of many medications and nondrug therapies that lower blood pressure. Increasingly, nonadherence to medication is found in approximately 2 of every 5 patients with uncontrolled hypertension. In the search for interventions that lower blood pressure that do not rely on adherence to a regimen requiring daily ingestion of medication or repeated physical activity, device-based methods that denervate the renal arteries have emerged as a potential complement to standard antihypertensive treatments. At least 3 different approaches to renal artery denervation are under active investigation, including the use of radiofrequency energy, ultrasound, or the injection of neurolytic agents into the renal perivascular tissue. In this review, we cover what is currently known about the mechanisms of antihypertensive effects of renal denervation, summarize the efficacy and safety of renal denervation using recent controlled trial publications in a number of hypertensive populations, and conclude with some thoughts about challenges in the field, including the optimization of patient selection for the procedure and what the reader can expect in the near future in this rapidly developing field.

尽管有许多降低血压的药物和非药物疗法，但不受控制的高血压仍然是一个重要的健康问题。越来越多地发现，每 5 名未控制的高血压患者中就有 2 名患者不依从药物治疗。在寻找不依赖于坚持每天服用药物或重复体育锻炼的方案来降低血压的干预措施时，基于设备的肾动脉去神经支配方法已成为标准抗高血压治疗的潜在补充。至少有 3 种不同的肾动脉去神经支配方法正在积极研究中，包括使用射频能量、超声或将神经溶解剂注射到肾血管周围组织中。在这篇评论中，