HypertensionRANSOMNCT04314557
Renal Arterial Denervation in Sympathetic Dysautonomia
An observational study of Hypertension and Renal Denervation, run by St Carlos Hospital, Madrid, Spain at 1 site in Spain.
Trial summary
The RANSOM registry is considered as a collection of data with the ultimate purpose of gathering information about the effect of renal denervation in patients of the investigator's center and evaluating the results within the usual clinical practice. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Hypertension, Renal Denervation, Increased Variability
- What is being tested?
- Renal denervation
- Type of treatment
- Medical device
- How many people
- 13 participants
- Where
- 1 siteSpain
- Study dates
- 14 Mar 2019to 31 May 2025
- How long will I take part?
- 12 Months
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: All comers.
Who may be able to join
- All patients included in a prospective manner must sign an informed written consent and meet ALL of the following criteria that are typical of the procedure according to the protocol of our center:
- Be considered adequate and eligible by the group of doctors responsible for the patient and by the multidisciplinary team of the study. Over 18 years, not pregnant.
- Poorly controlled arterial hypertension, under treatment with at least one antihypertensive drug.
- In addition, poorly controlled hypertension + increased variability, considering as such a standard deviation> 10 mmHg for systolic BP and> 5 for the diastolic BP of patient´s blood pressure levels, measured by ABPM.
- Renal arteries anatomy suitable for the procedure, considered by CT, MRI, ultrasound or angiography.
- Some criteria of dysautonomia, following the consensus of the American Autonomous Society (AAS) and the European Federation of Autonomous Societies (EFAS) of 2018.
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- or supine HTN. Defined as sBP ≥ 140 mmHg and / or dBP ≥ 90 mmHg, measured at least after 5 minutes of supine rest. Moderate forms (160-179 mmHg or dBP of 100-109 mmHg) or severe will preferably be included. (sBP≥ 180 mmHg and / or dBP ≥ 110 mmHg). Mild forms will be considered in conjunction with symptoms or other findings (ABPM) or nighttime HTN. Considered as such one that does not fall more than 10% compared to the daytime BP or even rises (riser). They will be considered in conjunction with symptoms or other findings (eg ABMP).
- If the foregoing is not fulfilled, marked orthostatism (> 30 mmHG in sBP and / or> 10mmHG in dBP).
- Life expectancy exceeding one year (not presenting terminal illness or any health condition for which a survival of less than one year is estimated).
Who cannot join
- eGFR <30 mL / min / 1.73m2.
- Monoxidin treatment.
- Impossibility of informed consent by the patient or legal representative.
- Impossibility for follow-up at least 1 year.
- Do not fulfill inclusion criteria, assessed by the multidisciplinary team.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Renal Arterial Denervation in Sympathetic Dysautonomia: RANSOM REGISTRY
The RANSOM registry is considered as a collection of data with the ultimate purpose of gathering information about the effect of renal denervation in patients of the investigator's center and evaluating the results within the usual clinical practice.
The general objective of the study is to evaluate the clinical results (blood pressure, quality of life and levels of catecholamines) as well as safety of renal sympathetic denervation in hypertensive patients, at least in treatment with an antihypertensive drug and with increased variability, considering as such a standard deviation> 10 mmHg for systolic BP and> 5 for diastolic BP of its blood pressure levels, measured by ABPM.
- Conditions
- Hypertension, Renal Denervation, Increased Variability, Blood Pressure Disorders, Blood Pressure Variability, Sympathetic Dysautonomia
- Being tested
- Renal denervation
- Keywords
- Sympathetic dysautonomia, Blood Pressure Variability, Hypertension, Renal denervation
- Medical subject headings
- Hypertension
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Renal denervationDevice
Spyral device. Bilateral renal denervation.
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in the descent of Systolic BP in orthostatism
BP Variability decrease, any (yes/no).
Measured: 12 months
Secondary outcomes (4)
Change in the descent of Systolic BP in orthostatism.
BP Variability decrease < 25 percent (yes/no)
Measured: 12 months
Measurement of quality of life and subjective perception of well-being.
Short form 12, questionaire (0-100, the higher the better).
Measured: 12 months
Evolution of blood pressure control, average levels and variability
AMPA measure mean PA levels (numeric)
Measured: 12 months
Safety end points
MACE (death,bleeding, renal failure-yes/no)
Measured: 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Mar 2020
- Study start14 Mar 2019
- Primary completion31 May 2025
- Study completion31 May 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (8)Papers the sponsor has linked to this study.
- Other trials for HypertensionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case only
- Time perspective
- Prospective
- Enrolment
- 13 participants (actual)
- Target duration
- 12 Months
Sponsor and investigators
- Lead sponsor
- St Carlos Hospital, Madrid, Spain
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, IVAN J NUÑEZ GIL, St Carlos Hospital, Madrid, Spain
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04314557
- Sponsor's protocol ID
- 18/532-O_P
- Acronym
- RANSOM
- Status last verified
- Jul 2025
- First submitted
- 16 Dec 2019
- Last updated
- 30 Jul 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- Undecided
Publications
Catala-Lopez F, Sanfelix-Gimeno G, Garcia-Torres C, Ridao M, Peiro S. Control of arterial hypertension in Spain: a systematic review and meta-analysis of 76 epidemiological studies on 341 632 participants. J Hypertens. 2012 Jan;30(1):168-76. doi: 10.1097/HJH.0b013e32834d30ec.
PubMed 22025240Kotseva K, De Bacquer D, De Backer G, Ryden L, Jennings C, Gyberg V, Abreu A, Aguiar C, Conde AC, Davletov K, Dilic M, Dolzhenko M, Gaita D, Georgiev B, Gotcheva N, Lalic N, Laucevicius A, Lovic D, Mancas S, Milicic D, Oganov R, Pajak A, Pogosova N, Reiner Z, Vulic D, Wood D, On Behalf Of The Euroaspire Investigators. Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions. Eur J Prev Cardiol. 2016 Dec;23(18):2007-2018. doi: 10.1177/2047487316667784. Epub 2016 Sep 27.
PubMed 27638542Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. doi: 10.1093/eurheartj/ehy339. No abstract available.
PubMed 30165516Hering D, Grassi G. Effects of renal denervation on short-term blood pressure variability: lack of meta-analytic evidence. J Hypertens. 2017 Sep;35(9):1780-1781. doi: 10.1097/HJH.0000000000001397. No abstract available.
PubMed 28767486Fanciulli A, Jordan J, Biaggioni I, Calandra-Buonaura G, Cheshire WP, Cortelli P, Eschlboeck S, Grassi G, Hilz MJ, Kaufmann H, Lahrmann H, Mancia G, Mayer G, Norcliffe-Kaufmann L, Pavy-Le Traon A, Raj SR, Robertson D, Rocha I, Struhal W, Thijs R, Tsioufis KP, van Dijk JG, Wenning GK. Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS) : Endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH). Clin Auton Res. 2018 Aug;28(4):355-362. doi: 10.1007/s10286-018-0529-8. Epub 2018 May 15.
PubMed 29766366Núñez-Gil IJ. Protocolo Asistencial de denervación renal percutánea mediante radiofrecuencia. Hospital Clínico San Carlos 2016.
Nunez-Gil IJ, Garcia-Donaire JA, Vedia O, Abad-Cardiel M, Martell-Claros N, Fernandez-Ortiz A. [Initial experience with a multi-electrode catheter in renal denervation. A technique that has come back to stay?]. Hipertens Riesgo Vasc. 2019 Jul-Sep;36(3):166-168. doi: 10.1016/j.hipert.2019.04.002. Epub 2019 May 31. No abstract available. Spanish.
PubMed 31160234Travieso-Gonzalez A, Nunez-Gil IJ, Riha H, Donaire JAG, Ramakrishna H. Management of Arterial Hypertension: 2018 ACC/AHA Versus ESC Guidelines and Perioperative Implications. J Cardiothorac Vasc Anesth. 2019 Dec;33(12):3496-3503. doi: 10.1053/j.jvca.2019.03.068. Epub 2019 Apr 3.
PubMed 31078374
Study at a glance
From the registry record, last updated by the sponsor on 30 Jul 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Renal Arterial Denervation in Sympathetic Dysautonomia: RANSOM REGISTRY
- ClinicalTrials.gov ID
- NCT04314557
- Acronym / sponsor ID
- RANSOM / 18/532-O_P
- Conditions
- Hypertension, Renal Denervation, Increased Variability, Blood Pressure Disorders, Blood Pressure Variability, Sympathetic Dysautonomia
- Keywords
- Sympathetic dysautonomia, Blood Pressure Variability, Hypertension, Renal denervation
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 13 participants (actual)
- Lead sponsor
- St Carlos Hospital, Madrid, SpainUniversity, hospital or other
- Study start
- 14 Mar 2019 (actual)
- Primary completion
- 31 May 2025 (actual)
- Study completion
- 31 May 2025 (actual)
- First posted
- 19 Mar 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The RANSOM registry is considered as a collection of data with the ultimate purpose of gathering information about the effect of renal denervation in patients of the investigator's center and evaluating the results within the usual clinical practice.
The general objective of the study is to evaluate the clinical results (blood pressure, quality of life and levels of catecholamines) as well as safety of renal sympathetic denervation in hypertensive patients, at least in treatment with an antihypertensive drug and with increased variability, considering as such a standard deviation> 10 mmHg for systolic BP and> 5 for diastolic BP of its blood pressure levels, measured by ABPM.
Study design
- Observational model
- Case only
- Time perspective
- Prospective
- Target follow-up
- 12 Months
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- All comers.
Key inclusion criteria (9 listed)
- All patients included in a prospective manner must sign an informed written consent and meet ALL of the following criteria that are typical of the procedure according to the protocol of our center:
- Be considered adequate and eligible by the group of doctors responsible for the patient and by the multidisciplinary team of the study. Over 18 years, not pregnant.
- Poorly controlled arterial hypertension, under treatment with at least one antihypertensive drug.
- In addition, poorly controlled hypertension + increased variability, considering as such a standard deviation> 10 mmHg for systolic BP and> 5 for the diastolic BP of patient´s blood pressure levels, measured by ABPM.
- Renal arteries anatomy suitable for the procedure, considered by CT, MRI, ultrasound or angiography.
Key exclusion criteria (5 listed)
- eGFR <30 mL / min / 1.73m2.
- Monoxidin treatment.
- Impossibility of informed consent by the patient or legal representative.
- Impossibility for follow-up at least 1 year.
- Do not fulfill inclusion criteria, assessed by the multidisciplinary team.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Renal denervationSpyral device. Bilateral renal denervation. | Device | – |
Primary outcome
Change in the descent of Systolic BP in orthostatism
Time frame: 12 months
BP Variability decrease, any (yes/no).
4 secondary outcomes
Change in the descent of Systolic BP in orthostatism.
Time frame: 12 months
Measurement of quality of life and subjective perception of well-being.
Time frame: 12 months
Evolution of blood pressure control, average levels and variability
Time frame: 12 months
Safety end points
Time frame: 12 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Jul 2025.
- Background: PubMed 22025240Catala-Lopez F, Sanfelix-Gimeno G, Garcia-Torres C, Ridao M, Peiro S. Control of arterial hypertension in Spain: a systematic review and meta-analysis of 76 epidemiological studies on 341 632 participants. J Hypertens. 2012 Jan;30(1):168-76. doi: 10.1097/HJH.0b013e32834d30ec.
- Background: PubMed 27638542Kotseva K, De Bacquer D, De Backer G, Ryden L, Jennings C, Gyberg V, Abreu A, Aguiar C, Conde AC, Davletov K, Dilic M, Dolzhenko M, Gaita D, Georgiev B, Gotcheva N, Lalic N, Laucevicius A, Lovic D, Mancas S, Milicic D, Oganov R, Pajak A, Pogosova N, Reiner Z, Vulic D, Wood D, On Behalf Of The Euroaspire Investigators. Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV cross-sectional survey in 14 European regions. Eur J Prev Cardiol. 2016 Dec;23(18):2007-2018. doi: 10.1177/2047487316667784. Epub 2016 Sep 27.
- Background: PubMed 30165516Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, Ruschitzka F, Schmieder RE, Shlyakhto E, Tsioufis C, Aboyans V, Desormais I; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-3104. doi: 10.1093/eurheartj/ehy339. No abstract available.
- Background: PubMed 28767486Hering D, Grassi G. Effects of renal denervation on short-term blood pressure variability: lack of meta-analytic evidence. J Hypertens. 2017 Sep;35(9):1780-1781. doi: 10.1097/HJH.0000000000001397. No abstract available.
- Background: PubMed 29766366Fanciulli A, Jordan J, Biaggioni I, Calandra-Buonaura G, Cheshire WP, Cortelli P, Eschlboeck S, Grassi G, Hilz MJ, Kaufmann H, Lahrmann H, Mancia G, Mayer G, Norcliffe-Kaufmann L, Pavy-Le Traon A, Raj SR, Robertson D, Rocha I, Struhal W, Thijs R, Tsioufis KP, van Dijk JG, Wenning GK. Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS) : Endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH). Clin Auton Res. 2018 Aug;28(4):355-362. doi: 10.1007/s10286-018-0529-8. Epub 2018 May 15.
- BackgroundNúñez-Gil IJ. Protocolo Asistencial de denervación renal percutánea mediante radiofrecuencia. Hospital Clínico San Carlos 2016.
- Background: PubMed 31160234Nunez-Gil IJ, Garcia-Donaire JA, Vedia O, Abad-Cardiel M, Martell-Claros N, Fernandez-Ortiz A. [Initial experience with a multi-electrode catheter in renal denervation. A technique that has come back to stay?]. Hipertens Riesgo Vasc. 2019 Jul-Sep;36(3):166-168. doi: 10.1016/j.hipert.2019.04.002. Epub 2019 May 31. No abstract available. Spanish.
- Background: PubMed 31078374Travieso-Gonzalez A, Nunez-Gil IJ, Riha H, Donaire JAG, Ramakrishna H. Management of Arterial Hypertension: 2018 ACC/AHA Versus ESC Guidelines and Perioperative Implications. J Cardiothorac Vasc Anesth. 2019 Dec;33(12):3496-3503. doi: 10.1053/j.jvca.2019.03.068. Epub 2019 Apr 3.
- Spyral device description/labelLink provided by the sponsor.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Hypertension and Renal Denervation, run by St Carlos Hospital, Madrid, Spain at 1 site in Spain.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in the descent of Systolic BP in orthostatism (time frame: 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04314557, which also lists 8 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Jul 2025.