Efficacy and Safety of Renal Denervation on Isolated Diastolic Hypertension

Inclusion criteria

• Age ≥18 years, with no restriction on sex or ethnicity;
• Diagnosis of primary hypertension, with no prior use of antihypertensive medication, and in the untreated state presenting with office systolic blood pressure (SBP) <140 mmHg and diastolic blood pressure (DBP) ≥90 mmHg, as well as 24-hour ambulatory blood pressure monitoring (ABPM) showing SBP <130 mmHg and DBP ≥80 mmHg;
• Willingness to participate and provision of written informed consent.

Exclusion criteria

• DBP ≥110 mmHg;
• Secondary hypertension;
• Requirement for antihypertensive or blood pressure-lowering medications due to comorbid conditions (e.g., SGLT2 inhibitors, GLP-1 receptor agonists);
• Cardiac arrhythmias interfering with blood pressure measurement (e.g., atrial fibrillation);
• Contraindications to RDN, including renal transplantation, renal insufficiency (eGFR <45 mL/min/1.73 m²), renal artery anatomy unsuitable for the procedure (inability to access the renal vasculature; renal artery diameter <4 mm or length <20 mm; hemodynamically or anatomically significant renal artery abnormalities or stenosis; prior coronary or renal artery interventions including angioplasty or stenting), and severe hepatic impairment;
• Contraindications to interventional procedures such as coagulopathy;
• Pregnancy, planning pregnancy, or breastfeeding;
• Life expectancy <1 year;
• Participation in another clinical trial.