The setback of renal denervation should not backfire on sympathetic overactivity in hypertension.

T he SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) study was a randomized, sham-controlled clinical study of the blood pressure (BP)-lowering effects of renal sympathetic denervation (RDN), which included ambulatory BPmeasurements (ABPM) as part of the inclusion criteria and as a secondary endpoint. The primary results of the study failed to show a larger reduction in office BP and ABPM compared with those of sham treatment at 6 months (1). In this issue of the Journal, the SYMPLICITY HTN-3 investigators report office systolic BP (SBP) and ABPM after 1 year in most of the patients originally randomized to RDN and in patients in the sham group who did and did not undergo RDN after 6 months (2).