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 leading cardiology journals, give RDN a Class IIb recommendation. RDN is recognised as an adjunct to lifestyle changes and medication for resistant or uncontrolled hypertension. Two FDA-approved devices are available: Medtronic’s Symplicity Spyral system and ReCor Medical’s Paradise ultrasound system. The Symplicity Spyral uses radiofrequency energy to disrupt renal artery nerves, while the Paradise system uses 360-degree ultrasound bursts with cooling protection. Guidelines recommend RDN for adults with persistent readings of at least 140/90 mm Hg despite medication. RDN is not advised for pregnant patients or those with significant renal artery narrowing. Medtronic cited its SPYRAL HTN programme, showing sustained blood pressure reductions for up to three years. ReCor said inclusion in the guidelines followed rigorous review of sham-controlled trials across varied populations. ReCor’s RADIANCE Global Program has demonstrated safe and effective blood pressure reduction with its uRDN system. Experts said the update could integrate RDN into treatment pathways for stage 2 hypertension patients intolerant to more drugs. Hypertension affects 1.28 billion adults worldwide, with nearly 80% not having their blood pressure under control. Medtronic said the update will improve access to RDN in the US and globally.