Renal Denervation Included in ACC/AHA 2025 High Blood Pressure Guideline

August 15, 2025—The American College of Cardiology (ACC) and the American Heart Association (AHA) separately announced publication of the 2025 multisociety guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. The new clinical guideline was published by Daniel W. Jones, MD, et al in the Journal of the American College of Cardiology and in the AHA journals Circulation and Hypertension.

According to ACC, the guideline for preventing and managing high blood pressure recommends healthy lifestyle behaviors combined with early treatment with medication to lower blood pressure, if necessary. These measures are recommended to reduce the risk of heart attack, stroke, heart failure, kidney disease, cognitive decline, and dementia. Additionally, the new guideline reflects several major changes since 2017, including use of the AHA’s PREVENT—predicting risk of cardiovascular disease events—risk calculator. Summaries and insights of the guideline are available online in the ACC and AHA announcements.

Medtronic and Recor Medical issued press releases noting that the new ACC/AHA hypertension guideline recognizes renal denervation (RDN) as an adjunctive care option for patients with resistant or uncontrolled hypertension.

In November 2023, FDA approval and the commercial launch of Medtronic’s Symplicity Spyral radiofrequency RDN system and Recor Medical’s Paradise ultrasound RDN system for treating hypertension were announced by the respective companies.

As noted by Medtronic, the guideline classifies the RDN procedure as a class IIb recommendation. The guideline comes after earlier consensus statements and guidelines from European countries underscoring the role of RDN as the third pillar in hypertension care, along with lifestyle modifications and medications, stated the company.

Medtronic stated that for RDN the new guideline outlines carefully selected patients, including adult patients with resistant or uncontrolled hypertension in whom blood pressure is not at goal despite taking antihypertensive medications and patients with systolic blood pressure ≥ 140 mm Hg and office diastolic blood pressure ≥ 90 mm Hg. Additionally, RDN is contraindicated in patients who are pregnant or with significant renal artery stenosis, among others. Furthermore, the guideline emphasizes patients with high cardiovascular risk, who remain uncontrolled, and who express a preference to undergo RDN in a tailored, shared decision-making process, reported Medtronic.

Recor stated that the 2025 guideline shows the growing confidence in RDN as a beneficial treatment option for patients with resistant or uncontrolled hypertension. The company further noted that the inclusion of RDN, grounded in an objective review of randomized, sham-controlled trials across diverse populations, affirms its relevance and offers health care professionals a robust foundation to incorporate this device-based therapy into hypertension management strategies.