Radiofrequency renal denervation provided sustained 5-year reductions in office systolic blood pressure of 32 mm Hg (95% CI -44 to -21; P<0.01) in patients with uncontrolled hypertension.
Cohort (n=83)
No
Does radiofrequency renal denervation reduce blood pressure in patients with uncontrolled hypertension?
Radiofrequency renal denervation provides significant and sustained blood pressure reductions over 5 years in patients with uncontrolled hypertension.
Mean Difference: -32 (95% CI -44–-21)
p-value: p=<0.01
Objective: Renal denervation (RDN) is a complementary treatment option for uncontrolled hypertension. Studies on sustained long-term blood pressure (BP) reduction are few. We here report on sustained 5-year BP reductions from the Swedish Registry for Renal Denervation. Design and method: All RDN procedures in Sweden are included in a national registry. We evaluated all 83 patients undergoing radiofrequency RDN in our institution 2011–25 for uncontrolled (resistant or drug intolerance) hypertension. Patients with secondary hypertension, eGFR <30 ml/min/m2, significant valvular disease, recent coronary or cerebrovascular events, pregnancy, or major renal artery abnormalities were ineligible. Follow-up was scheduled at 6, 12, 24, 36, 48, and 60 months. Means ± SD are shown, while linear mixed effects models (adjusted for age and number of antihypertensive drugs) display estimated marginal means with 95% CI. Results: Mean age was 58±13 years, 41% were female, 39% previous and 11% current smokers, 21% had diabetes, 19% chronic kidney disease, 5% heart failure, and 22% coronary artery disease or a previous TIA/stroke. Baseline office BP and average 24-h ABPM were 175±25/95±18 and 153±20/88±15 mm Hg, eGFR 74 ml/min/m2, and number of antihypertensive drugs 3.7±0.3. Changes at 6, 12, 24, 36, 48, and 60 months in office systolic and diastolic BP were -11 -3;-18, -18 -11;-26, -24 -15;-32, -31 -22;-40, -30 -20;-40, -32 -21;-44 and -2 +3;-7, -6 -1;-11, -9 -4;-14, -10 -4;-15, -10 -4;-17, -12 -5;-19 mm Hg for 75, 73, 66, 67, 59, and 54 patients, respectively; and in 24-h ABPM -2 +3;-12, -14 -8;-20, -12 -5;-18, -13 -6;-21, -7 +3;-16, -8 +2;-18 and -1.3 +3;-3, -7 -3;-11, -2 +2;-6, -8 -3;-13, -7 -1;-11, -8 -1;-14 mm Hg for 50, 41 32, 20, 14, and 13 patients, respectively. This indicates sustained 5-year reductions in both systolic and diastolic office and average 24-h ABPM values (all P(overall) <0.01). Number of antihypertensive drugs remained similar throughout, 3.8±0.3 at 60 months. There was a slow progressive decline in eGFR (-9±2 ml/min/m2) at 60 months, however not deemed clinically significant. Conclusions: Radiofrequency RDN offers significant and sustained 5-year BP reductions in patients with uncontrolled hypertension.
Jekell et al. (Fri,) conducted a cohort in Uncontrolled hypertension (n=83). Radiofrequency renal denervation was evaluated on Change in office systolic blood pressure at 60 months (MD -32 mm Hg, 95% CI -44 to -21, p=<0.01). Radiofrequency renal denervation provided sustained 5-year reductions in office systolic blood pressure of 32 mm Hg (95% CI -44 to -21; P<0.01) in patients with uncontrolled hypertension.