Renal denervation reduced office blood pressure by 10/6 mmHg (P<0.001) and 24-h ambulatory blood pressure by 7/4 mmHg at 6 months in patients with moderate treatment-resistant hypertension.
Cohort (n=40)
Does catheter-based renal denervation reduce blood pressure in patients with moderate treatment-resistant hypertension and confirmed medication adherence?
Catheter-based renal denervation significantly reduces both office and 24-hour ambulatory blood pressure in patients with moderate treatment-resistant hypertension and confirmed medication adherence.
Effect estimate: Office BP reduction -10/-6 mmHg
p-value: p=<0.001
OBJECTIVES: Data on the blood pressure (BP)-lowering effect of renal denervation (RDN) in moderate treatment-resistant hypertension (TRH) are limited. Moreover, change of adherence to medication, as one potential confounder of BP response, has never been analyzed rigorously in this group of patients. We analyzed the effect of RDN on BP in patients with moderate TRH who were retrospectively found to be completely adherent to their antihypertensive medication. METHODS: Our study cohort comprised 40 patients with moderate TRH office BP ≥ 140/90 but <160/100 mmHg and 24-h ambulatory BP monitoring (ABPM) ≥130/80 mmHg who underwent catheter-based RDN. Further major inclusion criterion was complete adherence to their medication (≥80% intake of their prescribed antihypertensive drugs) at baseline (assessed by retrospective toxicological analysis). RESULTS: Six months after RDN, office BP was reduced by -10/-6 mmHg (SBP: 149 ± 6 vs. 139 ± 15 mmHg; DBP: 81 ± 12 vs. 75 ± 10 mmHg; both P < 0.001) and 24-h ABPM by -7/-4 mmHg (SBP: 150 ± 14 vs. 143 ± 16 mmHg, P = 0.005; DBP: 82 ± 10 vs. 78 ± 9 mmHg, P = 0.009). Number of prescribed antihypertensive medication 6.0 (5.0-6.0) vs. 5.5 (5.0-6.0), P = 0.013 and adherence rate (95.2 ± 7.6 vs. 91.7 ± 13.9%, P = 0.065) was slightly reduced 6 months after RDN, both likely to underestimate the true BP reduction. CONCLUSION: Thus, our data indicate that even after given full respect to drug adherence as potential confounder of BP response after RDN, both office and 24-h ABPM were substantially reduced in patients with moderate TRH.
Ott et al. (Wed,) conducted a cohort in moderate treatment-resistant hypertension (n=40). Renal denervation was evaluated on Change in office blood pressure and 24-h ambulatory blood pressure (Office BP reduction -10/-6 mmHg, p=<0.001). Renal denervation reduced office blood pressure by 10/6 mmHg (P<0.001) and 24-h ambulatory blood pressure by 7/4 mmHg at 6 months in patients with moderate treatment-resistant hypertension.