The Symplicity SPYRAL renal denervation (RDN) device is safe and effective in reducing blood pressure (BP) long-term in patients with uncontrolled hypertension, a new analysis of registry data shows. These data were presented by David E. Kandzari, MD, of the Piedmont Heart Institute, Atlanta, on Tuesday during a late-breaking clinical trial session at Cardiovascular Research Technologies (CRT) 2026 in Washington, D.C. Over 1 billion people in the world have hypertension. Lowering blood pressure (BP) in this population reduces the risk of death and adverse cardiovascular events. Uncontrolled hypertension is often treated with RDN, along with lifestyle changes and medications. The U.S. Food and Drug Administration (FDA)-approved the Symplicity SPYRAL RDN system (Medtronic) has been used to treat hypertension in over 2,000 patients across four clinical trials. Investigators in this present study utilized this pooled data set to evaluate changes in long-term BP and see how many patients experienced clinical benefits, Dr. Kandzari said. The global SYMPLICITY registry measured center and 24-hour ambulatory BP, medication information and safety outcomes in patients who received the device. Outcomes were also evaluated at 36-months follow-up. All patients with uncontrolled hypertension (office systolic BP≥140 mmHg at baseline). A total of 2,137 patients had undergone RDN with SPYRAL as of September 2025 (baseline, mean age=58 years; 38.8% female9, 29.9% type 2 diabetes). The mean baseline systolic BP was 163 mmHg, and baseline ambulatory systolic BP was 152 mmHg. At baseline, patients were on an average of 3.8 antihypertensive medications and 3.5 at 36-months. Significant reductions were seen in office and 24-hour ambulatory BP (office systolic BP: -18.1 ± 23.4 mmHg; 24-h ambulatory systolic BP: -13.3 ± 17.6 mmHg; office diastolic BP change: -8.1 ± 13.9 mmHg; 24-h ambulatory diastolic BP change: -8.7 ± 10.6 mmHg) (p<0.0001 compared with baseline). All-cause death, cardiovascular mortality, myocardial infarction (MI) and hospitalization for emergency due to hypertension rates were low. Procedural safety events and renal artery stenosis were rare. At 36-months follow-up, 87.6% of SPYRAL RDN patients had reduced BP of ≥10 mmHg from baseline and 24-hour ambulatory BP reduction of ≥ 5 mmHg or a reduction of at least one antihypertensive medication. The average office systolic BP change was -22.6 ± 18.1 mmHg (p<0.001). On average, 24-hour ambulatory systolic BP changed from -16.3 ± 16.0 mmHg at 36 months (p<0.001). “In this large, pooled cohort of patients treated with RF RDN using the Spyral device, there were significant and consistent BP reductions through 36 months with few adverse events,” Dr. Kandzari said. Dr. Kandzari also announced during his presentation that these results were accepted for publication in Eurointervention. Image Credit: Bailey G. Salimes, CRTonline.org Image Caption: David E. Kandzari, MD, of the Piedmont Heart Institute in Atlanta, presents his late-breaking clinical trial at Cardiovascular Research Technologies (CRT) 2026 in Washington, D.C.