Table 1.

An Example of Structured Drug Titration During Renal Denervation Trials

Step (Target Systolic BP <140 mm Hg)	Drug	Treatment Score
0 (not needed)	None	0
1 (if needed)	CCB: mid‐dose	1
2 (if needed)	ACE inhibitor or ARB: full dose	2
3 (if needed)	Hydrochlorothiazide 12.5 mg	3
4 (if needed)	Hydrochlorothiazide 25 mg	4
5 (if needed)	CCB: increase to full dose	5
6 (if needed)	Spironolactone or β‐blocker or clonidine	6
7 (if needed)	Spironolactone or β‐blocker or clonidine	7
8 (if needed)	Spironolactone or β‐blocker or clonidine	8

Abbreviations: ACE, angiotensin‐converting enzyme; ARB, angiotensin receptor blocker; BP, blood pressure; CCB, calcium channel blocker. Usually 2 to 3 weeks between steps. If target reached, no further steps even if BP fluctuates above target. For steps 6, 7, and 8, choice of drug and dose at investigator's discretion. If initial systolic BP ≥160 mm Hg, steps 1 and 2 can be combined. Fixed‐combination drug products can be used to decrease pill burden. In protocols where patients already receive drugs, step sequence will begin between steps 2 and 6 depending on number of drugs in the ongoing regimen.