The American College of Cardiology and American Heart Association have updated their hypertension guidelines to include renal denervation as a treatment option. The 2025 guidelines, published in major cardiology journals, assign RDN a Class IIb recommendation. RDN is recognised as an adjunct to lifestyle changes and medications for resistant or uncontrolled high blood pressure. Two FDA-approved devices are available: Medtronic’s Symplicity Spyral and ReCor Medical’s Paradise ultrasound systems. Symplicity Spyral uses radiofrequency energy to disrupt renal artery nerves, while Paradise delivers 360-degree ultrasound bursts with cooling protection. RDN is recommended for adults with blood pressure at or above 140/90 mm Hg despite medication. It is not advised for pregnant patients or those with significant renal artery narrowing. Medtronic cited SPYRAL HTN trial data showing sustained reductions in blood pressure for up to three years. ReCor said inclusion follows an objective review of sham-controlled trials in diverse populations. ReCor’s RADIANCE Global Program has consistently demonstrated safe, effective results for its uRDN system. Experts say the update could integrate RDN into care pathways for stage 2 hypertension patients unable to tolerate more medication. Hypertension affects 1.28 billion adults worldwide, with nearly 80% lacking blood pressure control. Medtronic said the change could expand global access to the Symplicity blood pressure procedure.