SPYRAL GEMINI Pilot Study

Inclusion Criteria:

All Subjects (both cohorts):

1. ≥18 and ≤80 years of age.

2. Diagnosed with HTN and has a baseline office SBP ≥150 mmHg and <180 mmHg and anoffice DBP ≥ 90 mmHg.

3. 24-hour average SBP ≥140 mmHg and <170 mmHg measured by ABPM at Baseline.

Exclusion Criteria:

1. Individual lacks appropriate renal artery OR common hepatic artery anatomy.

2. Prior renal or hepatic denervation.

3. History of NYHA Class III or IV heart failure within 6 months of screening visit.

4. Stroke or transient ischemic attack (TIA) within 6 months of screening visit or anyhistory of stroke leading to permanent disability.

5. Documented Type 1 diabetes or use of insulin within 6 months.

6. Secondary cause of hypertension.

7. Documented condition that would prohibit or interfere with ability to obtain anaccurate blood pressure measurement.

8. Estimated glomerular filtration rate (eGFR) of <40

9. Pregnant, nursing or planning to become pregnant during the study.

10. Primary pulmonary arterial hypertension.

11. History or evidence of active / suspected chronic liver or biliary disease.

12. Current or chronic pancreatitis.