About

Raymond R. Townsend, MD, is an Emeritus Professor of Medicine and the Chief of Medicine (Renal-Electrolyte and Hypertension) at the University of Pennsylvania School of Medicine. He serves as the Director of the Hypertension Section within the Department of Internal Medicine/Renal. His research interests include the progression of chronic kidney disease, insulin resistance, measurement of vascular compliance, euglycemic clamp technique, minimal model for glucose kinetics, stable isotope metabolism, indirect calorimetry, measurement of regional blood flow, and measurement of glomerular filtration rate (GFR). Dr. Townsend's clinical expertise focuses on hypertension, including cases associated with adrenal tumors such as Pheochromocytoma and Paraganglioma, as well as conditions like Conn's Syndrome, Aldosterone Excess, hypertension with renal vascular disease, and refractory (drug-resistant) hypertension. His educational background includes a B.A. in Biology from LaSalle College and an M.D. from Hahnemann University. He has contributed to the field through numerous publications and is actively involved in research related to nephrology and hypertension.

Research topics

• Medicine
• Internal medicine
• Cardiology
• Anesthesia
• Radiology
• Pathology
• Urology
• Endocrinology
• Gastroenterology
• Surgery

Selected publications

• 26-A-15422-ACC REDUCING HYPERTENSIVE URGENCY WITH RADIOFREQUENCY RENAL DENERVATION THROUGH THREE YEARS: INSIGHTS FROM THE SPYRAL HTN-ON AND OFF MED TRIALS

  Journal of the American College of Cardiology · 2026-03-27

  articleSenior author
  PublisherDOI

• 300.05 Radiofrequency Renal Denervation Reduces Hypertensive Urgencies with Potential Healthcare Cost Savings in the United States: Two-Year Pooled Analysis of Randomized, Sham Controlled Trials

  JACC: Cardiovascular Interventions · 2026-03-01

  articleSenior author
  PublisherDOI

• Five-Year Risk Prediction Models for Peripheral Artery Disease in Patients With Chronic Kidney Disease

  Kidney Medicine · 2026-04-03

  articleOpen access

  Rationale & Objective: Patients with chronic kidney disease (CKD) have an increased risk of peripheral artery disease (PAD), yet no PAD risk-prediction models currently exist for this population. We developed and internally validated 5-year PAD risk-prediction models for individuals with CKD. Study Design: Prospective cohort study. Setting & Participants: 3,076 patients with CKD without PAD from the Chronic Renal Insufficiency Cohort (CRIC) study. Exposure: Clinically available variables, ankle-brachial index (ABI), and non-routinely measured cardiovascular disease biomarkers assessed at baseline. Outcomes: New-onset adjudicated clinical PAD event or an ABI ≤0.9 at an annual follow-up visit. Analytical Approach: Cox proportional hazards models were applied to estimate 5-year risk of incident PAD from baseline. Model performance was assessed by discrimination, calibration, and net reclassification improvement. All models were internally validated using Monte Carlo cross-validation. Results: <0.001). The biomarker-enhanced model achieved an AUC of 0.724 (95% CI, 0.711-0.745), which was not significantly different from the clinical model with ABI. Both the clinical model with ABI and the biomarker-enhanced model were well calibrated and improved reclassification of non-events compared with the ABI model (19.7%; 95% CI, 17.5-22.0% and 22.2%; 95% CI, 19.8-24.5%, respectively). Limitations: Lack of external validation. Conclusions: A PAD risk prediction model that combines clinical variables with ABI improves the identification of patients with CKD at high risk for PAD better than ABI alone.

  PublisherDOI

• MON-302 The Design of MOMENTUM: A Prospective Study of the Prevalence of Endogenous Hypercortisolism in Individuals With Resistant Hypertension

  Journal of the Endocrine Society · 2025-10-01

  articleOpen access

  Abstract Disclosure: J. Plutzky: Altimmune, Amgen Inc, Boehringer Ingelheim, Corcept Therapeutics, New Amsterdam, Novo Nordisk, Toku Eyes, Esperion, Novartis Pharmaceuticals. R.J. Auchus: Neurocrine Biosciences/Neurocrine UK, LTD, Spruce Biosciences, Corcept Therapeutics, Crinetics Pharmaceuticals, Recordati Rare Diseases, Adrenas Therapeutics, Mineralys Therapeutics, Quest Diagnostics, Xeris Pharmaceuticals, Novo Nordisk, H Lundbeck A/S, Sparrow Pharmaceuticals, Astellas Pharmaceuticals, Acerand Therapeutics. J.N. Basile: Eli Lilly &amp; Company, Novo Nordisk, Recor, Medtronic, Idorsia, Mineralys, Corcept Therapeutics, Ablative Solutions. D.L. Bhatt: Corcept Therapeutics. M.J. Bloch: Recor, Amgen Inc, SoniVie, Medtronic, Esperion, Jansen Pharmaceuticals, Novartis Pharmaceuticals, Idorsia, Barologics, Corcept Therapeutics. M.A. Cavender: Amgen Inc, Boehringer Ingelheim, Cleerly, CSL Behring, Janssen Research &amp; Development Company, Novo Nordisk, Novartis Pharmaceuticals, Silence Therapeutics, Massachusetts General Hospital/PCORI, AbbVie, Bayer, Inc., Corcept Therapeutics, Faraday Pharma, New Amsterdam Pharma. J.W. Findling: Corcept Therapeutics, Diurnal, Crinetics, Recordati. Y. Handelsman: Amgen Inc, Applied Therapeutic, Corcept Therapeutics, Ionis Pharmaceuticals Inc., Lilly USA, LLC, Merck, 89Bio, Arrowhead, AstraZeneca, Bayer, Inc., Boehringer Ingelheim, Esperion, Mankind Pharma, Merck, Merck-Pfizer, Novartis Pharmaceuticals, Novo Nordisk, Sanofi, Regeneron. S.E. Inzucchi: Boehringer Ingelheim, Lilly USA, LLC, AstraZeneca, Novo Nordisk, Merck, Pfizer, Inc., Bayer, Inc. N.E. Lepor: Amgen Inc, Arrowhead, AstraZeneca, Bayer, Inc., Esperion, Ionis Pharmaceuticals Inc., Merck, Novartis Pharmaceuticals, Novo Nordisk, Regeneron, Boehringer Ingelheim, Bristol-Myers Squibb, Corcept Therapeutics, Lexicon. N.J. Pagidipati: Alnylam, Amgen Inc, Bayer, Inc., Boehringer Ingelheim, Eli Lilly &amp; Company, Novartis Pharmaceuticals, Novo Nordisk, Merck, Corcept Therapeutics, Coursera, Esperion, AstraZeneca, New Amsterdam, Miga Health. R.R. Townsend: Medtronic, Regeneron, AstraZeneca, BD, Orchestra Backbeat, Axio/Cytel, Novartis Pharmaceuticals, UpToDate. M.R. Weir: AstraZeneca, Novo Nordisk, Bayer, Inc., CSL Vifor, Mineralys, Vera, Corcept Therapeutics. I. Tudor: Corcept Therapeutics. D. Einhorn: Corcept Therapeutics. Hypertension affects up to 50% of US adults. Despite the availability of multiple medications, resistant hypertension (rHTN) occurs in 10-20% of cases. Endogenous hypercortisolism (eHC) may contribute to rHTN in some individuals through several mechanisms. The prevalence of eHC in individuals with rHTN in the US is currently unknown, and screening for eHC is low due to the perceived rarity and screening challenges of eHC. Recent data from CATALYST, the largest prospective study assessing eHC prevalence in individuals with difficult-to-control type 2 diabetes, reported a 40% prevalence of eHC in the subgroup of participants who also had systolic blood pressure (BP) ≥135 mm Hg despite taking ≥3 BP medications (Handelsman Y, et al. WCIRDC 2024. Poster 0050). Furthermore, CATALYST demonstrated that eHC screening could consist of a 1-mg overnight dexamethasone suppression test (DST) readily performed in clinical practice. These findings establish the need to investigate eHC prevalence in individuals with rHTN. MOMENTUM is the first large, prospective study to examine the prevalence of eHC in people with rHTN in the US. MOMENTUM is an observational study with a planned enrollment of ∼1,000 individuals aged ≥18 years with rHTN using American Heart Association criteria: A) Systolic BP above target (≥130 mm Hg) despite concurrent use of ≥3 antihypertensive medications from different classes, including a diuretic, at their maximally tolerated doses, or B) BP at &amp;lt;130 mm Hg or above target requiring concurrent use of ≥4 antihypertensive medications of different classes. An average of 3 automated in-office BP measurements will be taken at intervals of 2-3 minutes between readings. Key exclusion criteria are investigator-determined white coat hypertension, nonadherence to BP medications, and individuals in whom DST may be difficult to interpret, including systemic glucocorticoid exposure ≤3 months before screening, a history of an estimated glomerular filtration rate &amp;lt;30 mL/min/1.73 m2, severe untreated sleep apnea, or dexamethasone serum levels inadequate for suppression. eHC is defined by post-DST cortisol &amp;gt;1.8 µg/dL. Participants with eHC will undergo non-contrast adrenal CT scans and 8 AM adrenocorticotropic hormone and cortisol tests. Participants will be screened for primary aldosteronism and other causes of endocrine hypertension. The primary endpoint is to assess the eHC prevalence in this population. Key secondary endpoints are to assess clinical and laboratory features associated with increased eHC risk. Descriptive statistics will be used to characterize participants with and without eHC in the enrolled population. In conclusion, the MOMENTUM study, as designed and currently enrolling, will provide an estimate of eHC prevalence and its associated clinical characteristics in people with rHTN. Presentation: Monday, July 14, 2025

  PublisherDOI

• TCT-571 First Report of the SPYRAL AFFIRM Study: Reduced Blood Pressure Following Radiofrequency Renal Denervation in a Large US Cohort of High Cardiovascular Risk Patients

  Journal of the American College of Cardiology · 2025-10-01

  article
  PublisherDOI

• 200.03 Blood Pressure Reductions After Radiofrequency Renal Denervation by Patient Age Based on Medicare Eligibility: SPYRAL HTN-OFF and -ON MED 24-Month Results

  JACC: Cardiovascular Interventions · 2025-02-01

  article
  PublisherDOI

• Two-year nighttime blood pressure changes after radiofrequency renal denervation: pooled results from the SPYRAL HTN trials

  Hypertension Research · 2025-04-02 · 1 citations

  articleOpen accessSenior author

  Elevated nighttime blood pressure (BP) and abnormal circadian dipping patterns are associated with advanced age and coexisting illnesses and are attributed to autonomic dysfunction. Radiofrequency renal denervation (RF RDN) effectively lowers BP throughout 24 h and thus may provide an effective antihypertensive therapeutic option. This analysis assesses the effects of RDN on nocturnal hypertension with different dipper patterns defined by nighttime/daytime BP ratio (i.e. dippers, non-dippers, risers) through 2 years in patients randomized to RDN from the SPYRAL HTN-OFF MED and -ON MED trials. Office and 24-h ambulatory BP, were also evaluated in patients stratified by age, obstructive sleep apnea (OSA), type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). Among 388 patients, the baseline nighttime systolic BP (SBP) was 139.3 ± 11.3 mmHg. Patients with a riser pattern had the highest baseline nighttime SBP (152.7 ± 8.0 mmHg). At 2 years, patients experienced a significant reduction from baseline (p < 0.0001) in nighttime (-12.0 ± 17.1 mmHg), morning (-14.8 ± 20.0 mmHg), daytime (-13.8 ± 14.7 mmHg), and 24-h SBP (-13.4 ± 14.2 mmHg). The greatest reduction in SBP was in risers at nighttime (-23.7 ± 14.3 mmHg). RDN was equally effective in lowering nighttime BP in patients ≥65 years old or with OSA, CKD, or T2DM. In this pooled dataset of RF RDN patients, clinically meaningful reductions in BP over a 24-h period were observed through 2 years irrespective of dipping status. RF RDN may reduce the risk of cardiovascular outcomes in patients with uncontrolled hypertension, especially in those with elevated nighttime BP who may be the most challenging to treat.

  PublisherOA PDFDOI

• REDUCING HYPERTENSIVE URGENCY THROUGH RADIOFREQUENCY RENAL DENERVATION: INSIGHTS FROM SPYRAL HTN-OFF AND -ON MED TRIALS

  Journal of Hypertension · 2025-05-01

  articleSenior author

  Objective: Hypertensive urgency is a common medical emergency, which can lead to progressive end-organ damage. Radiofrequency (RF) renal denervation (RDN) is safe and effective in reducing uncontrolled blood pressure (BP). In this post hoc analysis of randomized, sham-controlled trials (SPYRAL HTN-OFF MED and -ON MED), we assessed whether RDN reduces the incidence of hypertensive urgency. Design and method: Patients with office systolic BP (OSBP) 150-180 mmHg, office diastolic BP (ODBP) >=90 mmHg, and 24-h ambulatory systolic BP 140-170 mmHg were enrolled. Patients were randomized to RF RDN treatment with the Symplicity Spyral catheter or a sham procedure. Patients in OFF MED trial had no antihypertensive (AH) medications prior to enrollment and remained off AH medications through 3 months. ON MED trial patients were prescribed 1-3 AH medications through 6 months. Drug testing assessed AH medication adherence at baseline and follow-up. Hypertensive urgencies were defined as OSBP >=180mmHg or ODBP >=120mmHg. Kaplan-Meier estimates for the cumulative incidences of hypertensive urgency were compared between RDN vs control groups. OFF MED patients were censored after the primary endpoint (3 months) when AH medications were (re)introduced. Results: Across the SPYRAL HTN-OFF MED and ON MED trials, 388 patients and 315 patients were randomized to RDN and sham control, respectively. Kaplan-Meier estimates showed that patients who underwent RDN had a significantly lower rate of hypertensive urgencies compared to sham control patients (12.6% vs. 20.8%; p=0.0053; Figure). In the subgroup of ON MED trial patients who experienced a hypertensive urgency, 55.0% in the RDN group and 78.9% in the control group (p=0.18) were fully adherent to prescribed AH drugs at baseline. Conclusions: Patients who underwent RDN were significantly less likely to experience a hypertensive urgency compared with sham control patients. In the patients who had hypertensive urgency, non-adherence to AH drugs was prevalent in both RDN and control groups at baseline. This highlights the value of a non-pharmacological therapeutic option such as RDN to control BP and reduce the risk of hypertensive urgency.

  PublisherDOI

• Incident Hypertension: Much Ado About Something

  Mayo Clinic Proceedings · 2025-05-01

  editorial1st authorCorresponding
  PublisherDOI

• Modest Blood Pressure Increase with Age in Adults with Down’s Syndrome

  New England Journal of Medicine · 2025-04-03 · 1 citations

  letterOpen accessSenior author
  PublisherOA PDFDOI

Recent grants

• NIH Grant K24DK002684

  NIH · $541k · 2004

• Prospective renal insufficiency cohort evaluation: PRICE

  NIH · $17.0M · 2001–2026

• NIH Grant R01DK067390

  NIH · $4.3M · 2015

Frequent coauthors

• Mahboob Rahman

  868 shared

• Jiang He

  Central South University

  663 shared

• Harold I. Feldman

  University of Illinois Chicago

  653 shared

• Julio A. Chirinos

  University of Pennsylvania

  578 shared

• James P. Lash

  Northwestern University

  546 shared

• Jackson T. Wright

  Case Western Reserve University

  545 shared

• Amanda H. Anderson

  Tulane University

  501 shared

• Dawei Xie

  491 shared