Renal afferent and efferent sympathetic nerves are involved in the regulation of 
blood pressure and have a pathophysiological role in hypertension. Renal 
sympathetic denervation is a novel therapeutic technique for the treatment of 
patients with resistant hypertension. Clinical trials of renal sympathetic 
denervation have shown significant reductions in blood pressure in these 
patients. Renal sympathetic denervation also reduces heart rate, which is a 
surrogate marker of cardiovascular risk. Conditions that are comorbid with 
hypertension, such as heart failure and myocardial hypertrophy, obstructive 
sleep apnoea, atrial fibrillation, renal dysfunction, and metabolic syndrome are 
closely associated with enhanced sympathetic activity. In experimental models 
and case-control studies, renal denervation has had beneficial effects on these 
conditions. Renal denervation could become a commonly used procedure to treat 
resistant hypertension and chronic diseases associated with enhanced sympathetic 
activation. Current work is focused on refining the techniques and 
interventional devices to provide safe and effective renal sympathetic 
denervation. Controlled studies in patients with mild-to-moderate, nonresistant 
hypertension and comorbid conditions such as heart failure, diabetes mellitus, 
sleep apnoea, and arrhythmias are needed to investigate the capability of renal 
sympathetic denervation to improve cardiovascular outcomes.