EnligHTN IV Trial - Multicenter Sham-controlled RCT of Renal Denervation for Hypertension

Inclusion Criteria: * Subject is ≥18 years of age and ≤ 80 years of age at time of informed consent for participation in the clinical investigation * Subject must be able and willing to provide written informed consent * Subject must be able and willing to comply with the required follow-up schedule * Subject has an office Systolic Blood Pressure ≥ 160 mmHg based on an average of 3 Blood Pressure readings at the confirmatory visit (except for subjects with Diabetes Mellitus Type II who must demonstrate an office Systolic Blood Pressure of ≥ 150 mmHg) * Subject has a daytime mean Systolic 24-hour Ambulatory Blood Pressure value of ≥ 140 mmHg as measured during the two week screening period and confirmed at the confirmatory visit * Subject is taking ≥ 3 antihypertensive medications concurrently at full tolerated doses (this must include one diuretic) or subject is taking a diuretic and has a documented intolerance to at least two (2) out of the three (3) remaining major classes of anti-hypertensives (ACE / ARB, Calcium Channel Blockers, Beta blockers and is unable to take 3 anti-hypertensive drugs) o Intolerance is defined as an absolute contraindication to an anti-hypertensive medication according to the approved labeling or an inability to take an anti-hypertensive medication as prescribed due to an adverse drug effect including an immune mediated response or interaction with other medications. * Subjects must be on a stable antihypertensive medication regimen for a minimum of 2 weeks prior to completing the initial screening visit and the medication regimen must remain unchanged during the 2 week screening period following signing consent. Subject must be assessed at the confirmatory visit with no expected changes for at least six (6) months Exclusion Criteria: * Subject has had a previous renal denervation attempt * Subject has known cause of secondary hypertension other than sleep apnea * Subjects with significant renovascular abnormalities such as renal artery stenosis \>30%, previous renal stenting or angioplasty, renal artery occlusion, renal vein thrombosis, renal aneurysm or renal atheroembolism * Subject has had a myocardial infarction, unstable angina pectoris, or cerebrovascular accident \< 180 days prior to enrollment * Subject has hemodynamically significant valvular heart disease as determined by a Study Investigator * Subject is expected to have any cardiovascular intervention within 180 days of enrollment * Subject has blood clotting abnormalities such as thrombocytopenia, hemophilia, or significant anemia * Subject life expectancy is \< 12 months, as determined by a Study Investigator * Subject is participating in another Clinical Investigation (IND or IDE) * Subject is pregnant, nursing, or of childbearing potential and is not using adequate contraceptive methods * Subject has active systemic infection as determined by a Study Investigator * Subject has main renal arteries with diameter(s) \< 4 mm in diameter or \< 20 mm in length or multiple renal arteries where the main renal arteries supply \<75% of the kidney * Subject has eGFR \< 45 mL/min per 1.73 m2 using the MDRD formula * Subject has evidence of significant AAA defined as an aneurysm size of ≥5.0 cm in width and/or involving the renal arteries, and/or requiring surgical or percutaneous intervention within 6 months of enrollment. * Subject has had \>1 in-patient hospitalization for a hypertensive crisis within 12 months * Subject has a condition which would interfere with the accurate interpretation of the study endpoints * Any condition that would prohibit or interfere with the ability to obtain accurate Blood Pressure measurements using the CIP specific automatic Blood Pressure monitor * Subject has Systolic Blood Pressure values which are greater than 20mmHg apart after six (6) measurements as assessed at the confirmatory visit