Systemic hypertension represents a significant global concern, because it 
contributes to vascular and renal morbidity, cardiovascular mortality, and 
economic burden, hence the impact of hypertension is a major issue in public 
health worldwide. Improving high blood pressure management is therefore 
fundamental to influencing clinical outcomes. Despite adherence to multiple 
available medical therapies, a significant proportion of patients has persistent 
blood pressure elevation, a condition termed "resistant hypertension". Renal 
sympathetic innervations contribute to lack of response of anti-hypertensive 
drugs through an imbalance of regulatory mechanisms. Renal afferent nerve fibers 
are responsible for sympathetic activation and contribute to blood pressure 
homeostasis while afferent signals from the kidneys are integrated at the 
central nervous system and enhance sympathetic nerve discharge. In this regard, 
a novel strategy that selectively removes these hypertensive contributors 
represents a new therapeutic opportunity. Recently, a catheter-based method to 
induce renal sympathetic denervation has been introduced into daily practice. 
Clinical evaluation of selective renal sympathetic denervation demonstrated a 
decrease of renal norepinephrine spillover and renin activity, an increase of 
renal plasma flow, and has confirmed clinically significant, sustained 
reductions in blood pressure in patients with resistant hypertension. This 
review summarizes the available data on the role of sympathetic activation in 
the pathophysiology of hypertension and the current concepts in transcatheter 
renal artery ablation with radiofrequency delivery for systemic hypertension. 
Suggestions regarding targets for future systemic hypertension management are 
also described.