Despite industry-wide contraction last year after Medtronic's SYMPLICITY, some believe a hypertension device is just around the corner. With a market estimated in the billions or even tens of billions of dollars, both Medtronic and Boston Scientific are launching redesigned studies, and a determined handful of medtech start-ups continue to pursue a device-based solution for treating hypertension with invasive and noninvasive approaches, including renal sympathetic denervation through radiofrequency, ultrasound, or drugs; neuromodulation in the forearm; and cold therapy to specialized cells in the neck.

Despite industry-wide contraction last year after Medtronic's SYMPLICITY, many agree the trial was flawed, and some believe a hypertension device is just around the corner. A determined handful of medtech start-ups continue to pursue a device-based approach, most by reducing “fight-or-flight” outflow from the sympathetic nervous system.

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With the announcement that Medtronic is going back to the clinical drawing board after the pivotal SYMPLICITY HTN-3 trial of its renal denervation device failed to meet its primary efficacy endpoint, the industry is taking a cautious but still optimistic stance on the highly touted potential treatment for resistant hypertension.