SPYRAL PIVOTAL - SPYRAL HTN-OFF MED Study

Inclusion Criteria:

- Individual has office systolic blood pressure (SBP) ≥ 150 mmHg and <180 mmHg and a
diastolic blood pressure (DBP) ≥ 90 mmHg after being off medications.

- Individual has 24-hour Ambulatory Blood Pressure Monitoring (ABPM) average SBP ≥ 140
mmHg and < 170 mmHg.

- Individual is willing to discontinue current antihypertensive medications.

Exclusion Criteria:

- Individual lacks appropriate renal artery anatomy.

- Individual has estimated glomerular filtration rate (eGFR) of <45.

- Individual has type 1 diabetes mellitus or poorly-controlled type 2 diabetes mellitus.

- Individual has one or more episodes of orthostatic hypotension.

- Individual requires chronic oxygen support or mechanical ventilation other than
nocturnal respiratory support for sleep apnea.

- Individual has primary pulmonary hypertension.

- Individual is pregnant, nursing or planning to become pregnant.

- Individual has frequent intermittent or chronic pain that results in treatment with
nonsteroidal anti-inflammatory drugs (NSAIDs) for two or more days per week over the
month prior to enrollment.

- Individual has experienced a myocardial infarction, unstable angina pectoris, syncope,
or a cerebrovascular accident within three months of the screening period, or has
widespread atherosclerosis, with documented intravascular thrombosis or unstable
plaques.

- Individual works night shifts.