# Exploring Potential Referral Pathways for Renal Artery Denervation and Developing a Centre of Excellence in Ireland

## TL;DR

This paper explores referral pathways for a new treatment for high blood pressure and outlines steps to create a specialized center in Ireland.

## Contribution

The paper proposes standardized referral structures for renal denervation in Ireland and outlines requirements for a center of excellence.

## Key findings

- Renal denervation is effective and safe for treating resistant hypertension.
- Referral pathways for the procedure are currently diverse and unstandardized in Ireland.
- Establishing a center of excellence could improve patient management and treatment outcomes.

## Abstract

Arterial hypertension is one of the most significant and prevalent risk factors for cardiovascular disease. Despite widespread awareness of the condition, as well as a multitude of available antihypertensive drug classes, rates of uncontrolled hypertension remain high on a global scale. Frequently, poor compliance with anti-hypertensive medication plays a big role in patients’ inability to attain adequate blood pressure control. In individuals with resistant and/or uncontrolled hypertension, renal denervation is an emerging device-based therapy that has shown to be efficacious and safe in reducing blood pressure in several sham controlled trials. Additionally, it represents a treatment option for patients intolerant to oral pharmacotherapy.

University Hospital Galway has been performing renal denervation procedures over the past number of years within multicentre, international sham-controlled trials and registries. Representing a novel and emerging antihypertensive treatment option, sources of referral for renal denervation are diverse and multiple; thus, there is an unmet need for standardised referral structures in Ireland. Herein, we review current and developing referral pathways for renal denervation at our institution, and discuss streamlined patient management and requirements to establish a centre of excellence.