Background: Hypertension is a major contributor to death. A significant portion of the patients is still in resistant hypertension with current medical treatment. Renal nerve denervation can reduce sympathetic activity, and subsequently reduce BP in western population.
Objective: To evaluate the effect of renal nerve denervation in treatment of resistant hypertension in Thai patients.
Material and Method: The present study is a case series of the first four Thai patients who underwent renal nerve denervation at Faculty of Medicine Siriraj Hospital. All patients had resistant hypertension. Baseline medical records, including demographic data, baseline systolic and diastolic blood pressure (BP), ambulatory BP monitoring, number and dose of anti-hypertensive medications before and after renal nerve denervation, were recorded. Patients were followed-up at 1 month, 3 month and 6 months after the procedure.
Results: Patients were taking antihypertensive medications ranging from 5 to 8 types of drug classes, but in all cases, their blood pressure was still not under control at baseline range from 160-190 of systolic BP and 100-120 mean BP. One of the patients had a history of hemorrhagic stroke as a consequence of un-control hypertension. All of them had blood pressure reduction immediately at the end of the first 24 hrs, and this was sustained until follow-up at 3-6 months. The mean of systolic BP reduction is 35.2+ 9.9 mmHg at 3-months follow-up. The mean reduction of the number of anti-hypertensive medications was 3.5+3.0 at 3-month follow-up.
Conclusion: The authors found that the percutaneous renal nerve denervation was very effective in blood pressure reduction in these first four cases of Thai patients with resistant hypertension.

Keywords: Resistant hypertension, Renal nerve denervation, Blood pressure reduction, Sleep apnea